V  B 

/e-73 
A* 


72    D71 


N.  M.  3. 

No. 

112321—2 


CIRCULAR 

RELATING  TO  THE 

PHYSICAL  EXAMINATION 
OF  RECRUITS 

FOR     ENLISTMENT     IN    THE 

NAVY  AND  MARINE  CORPS 


(FOR  THE  USE  OF  STUDENT  OFFICERS) 


WASHINGTON 

GOVERNMENT  PRINTING  OFFICE 
1916 


-, 


N.  M.  S. 

No. 

112321—2 


.CIRCULAR 

RELATING  TO  THE 

PHYSICAL  EXAMINATION 
OF  RECRUITS 

FOR     ENLISTMENT     IN     THE 

NAVY  AND  MARINE  CORPS 


(FOR  THE  USE  OF  STUDENT  OFFICERS) 


WASHINGTON 
GOVERNMENT  PRINTING  OFFICE 

1916 


V  73  2,  73 


BUREAU  or  MEDICINE  AND  SURGERY, 

NAVY  DEPARTMENT, 
^Washington,  D.  C.,  July  10,  1916. 

The  "  Circular  relating  to  the  physical  examination  of  recruits 
for  enlistment  in  the  Navy  and  Marine  Corps  "  is  issued  for  use  as  a 
textbook  by  student  officers  participating  in  the  naval  medical  corre- 
spondence course. 

This  circular  will  supersede  the  circular  entitled  "Extracts  from 
regulations  and  instructions  in  relation  to  the  physical  examination 
of  recruits  for  enlistment  in  the  Navy  and  Marine  Corps."  (N.  M.  S. 
No.  112321-1.  1912.) 

W.  C.  BRAISTED, 
Surgeon  General,  U.  S.  Navy. 

Approved. 

JOSEPHUS  DANIELS,  Secretary. 


366837 


CIRCULAR  RELATING  TO  THE  PHYSICAL  EXAMINATION  OF 
RECRUITS  FOR  ENLISTMENT  IN  THE  NAVY  AND  MARINE 
CORPS. 

[Extracts  from  the  Manual  for  the  Medical  Department  of  the  United  States  Navy  are 
incorporated  in  this  circular.  A  few  minor  changes  have  been  made  in  the  text.  The 
numbers  in  heavy-face  type  are  those  of  articles  in  the  manual.] 


CONTENTS. 

Page. 
Physical  examination  for  enlistment  (from  chap.  12,  Manual  for  the 

Medical  Department) 7 

Supplementary  notes  on  recruiting 21 

Instructions  in  opening  and  preparing  health  records  (from  chap.  13, 

Manual  for  the  Medical  Department) 23 

Identification  records  and  finger  prints . 27 

Hints  for  the  inexperienced  in  naval  and  marine  recruiting,  especially 

those  examiners  without  experience  at  sea 37 

Physical  examination  of  the  personnel  of  the  Naval  Militia  prior  to 

being  mustered  into  the  service  of  the  United  States 48 

5 


PHYSICAL    EXAMINATION    OF    RECRUITS    FOR    ENLIST- 
MENT IN  THE  NAVY  AND  MARINE  CORPS. 

\ 

[From  chap.  12,  Manual  for  the  Medical  Department.] 


ENLISTMENTS  IN   THE  NAVY LAWS  RELATING  TO   ENLISTMENT. 

2001.  Enlistment  of  minors,  deserters,  insane,  intoxicated,  etc., 
prohibited.    Sees.  1420,  1624  <19)  R.  S.;  acts  May  12,  1879,  Feb.  23, 
1881.  m 

2002.  Term  of  enlistment.     Sec.  K73,  R.  S.;  acts  Mar.  3,  1899, 
Aug.  22,  1912. 

2003.  Term  of  enlistment,  minors.    Sec.  1418,  R.  S. ;  acts  May  12, 
1879,  Feb.  23,  1881. 

2004.  Consent  of  parents  and  guardians  required  before  enlist- 
ment of  minors.    Sec.  1419,  R.  S. ;  acts  May  12, 1879,  Feb.  23, 1881. 

2005.  Enlistments  in  the  Marine  Corps.    Act  Mar.  3,  1901. 

2006.  Physical  examination  of  men  of  the  Naval  Militia  upon 
muster  into  service  of  the  United  States.     (Act  of  Feb.  16,  1914.) 

NAVY    REGULATIONS    AND    NAVAL    INSTRUCTIONS    RELATING    TO    PHYSICAL 
EXAMINATION  FOR  ENLISTMENT. 

2011.  Every  person  enlisted  must  pass  physical  examination  pre- 
scribed in  medical  instructions.     (I  3201-3212) ;  R  3523  (1). 

2012.  Finger  prints  to  be  taken.    R  3523  (2). 

2013.  Records  to  be  made  of  persons  enlisted  with  physical  dis- 
ability.   R3523  (3). 

2014.  Minors  under  14  years  of  age,  insane,  and  intoxicated  not  to 
be  enlisted.    R  3524  (2). 

2015.  Reenlistments  authorized  if  physically  qualified.    R  3526. 

2016.  Continuous-service  men  disqualified.     R  3528. 

2017.  Entries  to  be  made  in  service  record.    R  3541;  R  3542  (2). 

2018.  Marines    enlisted    must    pass    physical    examination.     R 
4151  (2). 

2019.  Reenlistment  of  marines  with  disability.    R  4151  (3). 

2020.  Disabilities  to  be  entered  on  enlistment  papers.    R  4151  (4). 

2021.  Persons  examined  physically  to  be  entered  on  card  (rough 
formX).    13201. 

2022.  Examination  to  be  conducted  by  medical  officer.    I  3202. 

2023.  Examination  to  be  completed  and  not  terminated  upon  dis- 
covery of  disqualification.    I  3203. 

2024.  Medical  officer  who  passes  recruit  subsequently  surveyed  to 
be  held  responsible.    I  3204. 

2025.  Inspection  and  inquiry  by  medical  officer.    I  3205. 

2026.  Intelligence  and  detection  of  mental  defects.    I  3206. 

2027.  Age  of  applicant  to  be  kept  in  mind.    I  3207. 

7 


8  PHYSICAL  EXAMINATION   OF  RECRUITS. 

2028.  Entries  to  be  niKeb  in  service  and  health  records.    I  3208. 

2029.  Defects  waived  by  department.    I  3209. 

2030.  Recmils  to  be  reovp  mined  on  receiving  ship.    R  3511 ;  I  3210. 

2031.  Recruits  to  be  immediately  vaccinated.    I  3211  (1). 

2032.  No  recruit  to  be  transferred  until  vaccinated.     I  3211  (2). 

2033.  Typhoid  prophylaxis  to  be  administered.    I  3212. 

2034.  Examination  of  eyesight  of  gun  pointers.    I  2501  (3). 

CIRCULARS   RELATING   TO   ENLISTMENT. 

2041.  Circular  relating  to  the  enlistment  of  men  for  the  United 
States  Navy.    July  20,  1912. 

2042.  Extracts  from  regulations  and  instructions  in  relation  to  the 
physical  examination  of  recruits. 

PHYSICAL    EXAMINATION    OF    RECRUITS    FOR    ENLISTMENT    IN    THE    NAVY 

AND  ^ARINE  CORPS. 

2051.  Whenever  any  person  is  examined  physically  for  the  Navy 
or  Marine  Corps,  whether  subsequently  enlisted  or  rejected,  his  name 
and  the  particulars  shall  at  once  be  entered  on  Form  X  (rough). 
This  form  shall  be  prepared  for  each  applicant  examined,  whether 
accepted  or  rejected,  for  original  or  reenlistment,  and  will  be  kept 
for  the  purpose  of  preparing  Form  X.    It  shall  be  retained  for  ship 
or  station  files  and  shall  be  filed  alphabetically,  by  calendar  years, 
according  to  the  applicant's  surname,  in  order  that  information  may 
be  furnished  the  bureau  upon  request. 

Be  careful  to  strike  through  with  ink  the  term  not  applicable  to  the 
case. 

Form  X  shall  be  prepared  from  the  Form  X  (rough)  kept  for  the 
purpose,  and  will  be  forwarded  from  receiving  ships,  Navy  and 
Marine  Corps  recruiting  stations,  and  marine  recruit  depots  for  the 
quarters  ending  March  31,  June  30,  September  30,  and  December  31 ; 
from  other  ships  and  naval  stations  or  yards  for  the  year  ending 
December  31,  or  when  a  ship  is  placed  out  of  commission  or  a  recruit- 
ing or  other  station  closed. 

A  copy  shall  be  retained  for  ship  or  station  files.  If  there  have 
been  "  No  applicants,"  the  report  shall  be  forwarded  and  this  fact  so 
stated  in  the  blank  spaces  opposite  "  Navy  "  and  "  Marine  Corps." 

Central  recruiting  stations  shall  include  in  their  report  the  sub- 
stations and  traveling  parties  coming  under  their  jurisdiction. 

Medical  officers  of  ships,  naval  stations,  or  yards  making  exam- 
inations for  ships  or  stations  to  which  no  medical  officer  is  assigned 
shall  include  these  items  in  their  reports. 

Civilian  examiners  at  substations  of  the  Marine  Corps  will  prepare 
and  forward  Form  X  (rough)  to  the  central  stations. 

2052.  In  case  a  waiver  is  requested,  the  action  will  be  noted  on 
Form  X  (rough)  after  the  cause  of  rejection,  and  approval  of  waiver 
shall  be  entered  en  this  form,  and  also  in  the  service  and  health 
records.     (R  3523  (3)  ;  I  3209.) 

2053.  Marine  recruit  depots  shall  distinguish  between  "Accepted 
applicants"  transferred  from  recruiting  stations  to  the  depot  and 
those  applying  originally  at  the  depot  by  making  the  proper  entry  in 
the  space  provided  on  this  form. 


PHYSICAL   EXAMINATION    OF    KECEUITS.  9 

2054.  Previous  Army  service  shall  not  be  considered  a  reenlist- 
ment.    Previous  Navy  or  Marine  Corps  service  shall  be  considered  a 
reenlistment  in  the  Navy,  and  previous  Marine  Corps  or  Naval  serv- 
ice shall  be  considered  a  reenlistment  in  the  Marine  Corps,  so  far  as 
it  applies  for  use  in  the  preparation  of  this  form. 

2055.  The  term  of  enlistment  of  all  enlisted  men  of  the  Navy 
shall  be  four  years,  except  minors  over  17  and  under  18  years  of  age, 
who  shall  be  enlisted  for  the  period  of  minority.     Minors  under  17 
can  not  enlist  in  the  Navy.     No  enlistment  for  special  service  is 
allowed. 

205(5.  No  minor  under  the  age  of  18  years  will  be  enlisted  without 
the  written  consent  of  the  parent  who  is  his  legal  guardian;  or,  if 
both  parents  are  dead,  of  a  legally  appointed  guardian. 

Minors  under  but  claiming  to  be  over  18  years  of  age  are  liable,  if 
enlisted,  to  punishment  for  fraudulent  enlistment  under  the  act  of 
Congress  approved  March  3,  1893. 

2057.  Only  such  persons  shall  be  enlisted  as  can  reasonably  be 
expected  to  remain  in  the  service,  and  when  enlisted  must  serve  out 
the  term  of  their  enlistment,  and  can  not  be  discharged  prior  to  that 
time,  except  for  cause  or  as  otherwise  provided. 

2058.  Every  person  before  being  enlisted  must  pass  the  physical 
examination  prescribed  in  the  medical  instructions,  and  no  person 
shall  be  enlisted  for  the  naval  service  unless  pronounced  fit  by  the 
commanding  and  medical  officers. 

2059.  No  person  other  than  a  medical  officer  shall  be  permitted  to 
conduct  any  part  of  a  physical  examination,  to  make  any  measure- 
ment, or  to  make  any  original  entry  on  any  medical  record  of  enlist- 
ment. 

2060.  Every  such  examination  must  be  completed  according  to  the 
official  forms,  and  shall  in  no  case  be  suspended  on  the  recognition 
of  a  disqualifying  defect. 

2061.  Medical  officers  on  recruiting  duty  shall  exercise  great  care 
and  thoroughness  in  conducting  the  physical  examination  of  persons 
presenting  themselves  for  enlistment.     While  these  instructions  are 
applicable  in  general  to  all  physical  examinations,  they  are  intended 
to  cover  more  particularly  the  examinations  of  applicants  presenting 
themselves  for  original  enlistment.    While  permitted  to  use  his  own 
discretion  as  to  the  routine  of  procedure,  the  medical  officer  shall 
make  inquiry  on  all  points  indicated  below :  After  testing  the  vision, 
color  perception,  and  hearing,  and  estimating  the  general  fitness  of 
the  applicant,  his  height,  weight,  and  chest  measurements  mav  be 
taken  and  recorded,  the  clothing  having  been  removed.    A  general 
inspection  and  regional  examination  is  then  made,  as  follows : 

(a)  The  applicant,  entirely  nude,  is  to  stand  before  the  examiner, 
in  a  bright  light,  and  present  successively  front,  rear,  and  sides. 
(Retarded  development,  deformity  or  asymmetry  of  body  or  limbs, 
knock-knees,  bowlegs,  or  flat  feet,  especially  in  minors ;  spinal  curva- 
tures ;  feebleness  of  constitution ;  strumous  or  other  cachexia ;  emaci- 
ation, obesity;  cutaneous  or  other  external  disease;  glandular  swell- 
ings or  other  tumors;  nodes;  varicosities,  cicatrices;  indications  of 
medical  treatment,  leech  bites,  blister  stains,  seton  or  scarification 
scars ;  and  evidences  of  smallpox  or  successful  vaccination,  or  the  ad- 
ministration of  salvarsan. 

51677°— 16 2 


10  PHYSICAL  EXAMINATION    OF   RECRUITS. 

(&)  Applicant  to  present  dorsal  and  palmar  surfaces  of  both 
hands ;  to  flex  and  extend  every  finger ;  to  grasp  with  thumb  and  fore- 
finger and  with  whole  hand ;  to  flex  and  extend,  pronate  and  supinate 
wrists  and  forearms;  to  perform  all  the  motions  of  shoulder  joints, 
especially  circumduction ;  to  extend  arms  at  right  angles  to  body,  and 
then  bend  elbow  and  touch  the  shoulders  with  the  fingers ;  to  elevate 
extended  arms  above  the  head,  palm  to  palm,  then  dorsum  to  dorsum ; 
to  evert  and  invert  the  feet ;  to  stand  on  tiptoe,  coming  down  upon  the 
heels  quickly,  and  then  lifting  toes  from  floor;  to  flex  each  thigh  al- 
ternately upon  the  abdomen,  and,  while  standing  on  one  leg,  to  hop ; 
to  perform  all  the  motions  of  the  hip  joint;  and  to  walk  backward 
and  forward  slowly  and  at  double-quick. 

(c)  Note  effect  of  these  violent  exercises  on  the  heart  and  lungs; 
observe  movements  of  chest  during  prolonged  inspiration  and  ex- 
piration; examine  by  percussion  and  auscultation  front  and  rear. 
(Incipient  tuberculosis,  valvular  disease.)     Care  should  be  taken  to 
differentiate  between  organic  murmurs  and  the  functional  varieties. 

(d)  With  hands  on  the  head  and  chin  up,  applicant  to  cough  vio- 
lently  (relaxation  of  umbilical  and  inguinal  regions;  hernia;  con- 
cealed   venereal    disease,    especially    beneath    prepuce    and    within 
urethra ;  varicocele ;  orchitis  and  other  abnormal  conditions  of  testes) . 

(e)  Applicant  to  bend  body  forward,  with  knees  stiffened,  feet 
wide  apart,  hands  touching  the  floor,  and  nates  exposed  to  strong 
light    (hemorrhoids;   prolapsus,   fistula?).     While  the   applicant  is 
stooping  make  firm  pressure  on  the  spinous  process  of  each  vertebra 
(noting  spinal  tenderness). 

(/)  Motions  of  head,  neck,  and  lower  jaw. 

(g)  Cranium  and  scalp  (malformations,  depressions,  cicatrices, 
tinea,  vermin,  etc.). 

(k)  Ears  (polypi;  otorrhea,  perforation,  dullness  of  hearing,  and 
degeneration  stigmata). 

(i)  Mastoid  region  for  scars  or  tenderness. 

(j)  Eyes  (absence  of  cilia?,  tarsal  redness,  obstructed  puncta, 
cprneal  opacities,  adhesions  of  iris,  defective  vision,  abnormal  condi- 
tions of  conjunctiva?,  trachoma,  pterygium). 

(&)   Nose  (polypi;  ozena;  chronic  nasal  catarrh). 

(I)  Mouth,  teeth,  tongue,  fauces  (hypertrophied  tonsils ;  syphilitic 
affections,  impediments  of  speech,  lingual  scars,  cleft  palate,  and  re- 
pulsive stigmata  or  scars  of  the  face,  grotesque  tattooing,  or  the  ex- 
pression characteristic  of  adenoids). 

2062.  No  educational  standard  has  been  officially  established  for 
recruits  presenting  themselves  for  enlistment  in  the  naval  service. 
The  regulations  require,  however,  that  a  candidate  shall  be  able  to 
read  and  write  and  that  he  should  possess  a  reasonably  quick  and 
clear  understanding.    His  general  intelligence  may  be  estimated  by 
his  manner  of  answering  the  questions  addressed  to  him  in  obtaining 
the  data  required  in  the  health  record,  and  any  impediments  of  speech 
noted. 

2063.  Section  1420  of  the  Revised  Statutes  forbids  the  enlistment 
in  the  naval  service  of  any  intoxicated  person.    The  evident  intention 
of  the  law  was  not  only  to  prevent  the  admission  into  the  service  of 
men  who  at  the  time  of  presenting  themselves  for  enlistment  were 
under  the  influence  of  alcoholic  stimulants  or  drugs,  but  of  those  also 
who  were  of  intemperate  habits,    A  thorough  inquiry  should  be  made 


PHYSICAL   EXAMINATION   OF   RECRUITS,  11 

into  the  history  of  any  applicant  in  which  habits  of  intemperance 
are  suspected.  Long  indulgence  in  habits  of  intemperance  will  be 
indicated  by  persistent  redness  of  the  eyes,  tremulousness  of  the 
hands,  sluggishness  of  the  intellect,  satinlike  texture  of  the  skin  of 
the  body,  an  eruption  upon  the  face,  and  purple  blotches  upon  the 
legs.  The  morphine  habitue  is  often  emaciated,  prematurely  senile, 
with  foul  breath,  contracted  pupils,  peculiar  pallor,  dry  skin,  and 
often  showing  multiple  punctures  of  the  skin  from  the  needle.  The 
habitual  user  of  cocaine  may  be  suspected  when  the  applicant  ex- 
hibits unusual  buoyancy  and  mental  overactivity  accompanied  by 
irrelevant  volubility.  Cocaine  "  snuffers  "  will  usually  show  a  charac- 
teristic hyperemia  of  the  nasal  mucous  membrane.  Medical  officers 
should  endeavor  to  eliminate  the  insane,  vagrant,  and  criminal  classes 
by  a  careful  study  of  the  personal  characteristics  of  each  applicant. 
Any  doubt  as  to  the  mental  stability  of  the  applicant  should  deter- 
mine a  careful  investigation  directed  toward  his  previous  history. 

2064.  Certain  defects  which  are  frequently  found  associated  with 
the  physical  condition  in  cases  of  reenlistment  or  continuous  service 
are  not  necessarily  causes  of  rejection.    If  deemed  of  sufficient  im- 
portance to  cause  rejection,  a  waiver  of  the  defects  may  be  recom- 
mended, provided  that  such  disabilities  will  not  interfere  with  the 
performance  of  duty.    Waiver  is  requested  on  "  Report  of  Rejection," 
procurable  from  Bureau  of  Navigation  (Form  No.  54).    This  report 
shall  be  forwarded  in  all  cases  of  physical  rejection  of  continuous- 
service  men.     (R.  3528.)     Physical  infirmities  incident  to  advanced 
years  and  long  service  should  be  carefully  considered  in  these  exami- 
nations and  especially  in  the  case  of  reenlistment  under  continuous 
service.     Slight  physical  defects  in  those  applicants  who  have  ma- 
tured are  of  less  importance  than  when  occurring  in  minors. 

Physical  disqualifications  of  a  minor  nature  of  probably  temporary 
duration  readily  amenable  to  medical  or  surgical  treatment  should 
not  necessarily  cause  rejection,  if  the  candidate  is  otherwise  qualified 
and  desirable.  Application  will  be  made  to  the  bureau  for  the  admis- 
sion to  hospital  of  such  cases  as  supernumeraries  for  treatment  of 
such  duration  as  may  be  desirable,  having  in  view  the  removal  of  dis- 
qualifying defects  and  the  ultimate  enlistment  of  a  candidate  who  is 
in  all  "other  respects  qualified.  In  stating  the  cause  of  rejection  in 
such  cases  ambiguous  terms  should  be  avoided  and  the  degree  of 
visual  and  auditory  defects  should  be  given.  (M.  and  S.  No.  123734.) 

2065.  The  examining  surgeon  shall  consider  carefully  the  physical 
adaptability  of  the  applicant  in  relation  to  the  character  of  the  duties 
which  he  may  be  called  upon  to  perform.    Moderate  height  and  com- 
pact build  are  requisite  in  the  ratings  of  fireman  and  coal  passer. 
The  duties  pertaining  to  these  ratings  are  extremely  arduous,  and 
applicants  for  such  positions  and  candidates  for  transfer  to  these 
ratings  must  conform  in  every  particular  to  the  required  physical 
standard.    As  a  general  rule  minors  should  not  be  recommended  for 
the  ratings  of  fireman  and  coal  passer. 

2066.  Slight  physical  defects  in  applicants  who  belong  to  the  sea- 
faring class,  or  in  those  who  have  had  experience  in  military  life, 
have  less  significance  than  they  might  otherwise  have  in  the  cases  of 
recruits  whose  lives  have  been  passed  in  occupations  of  a  more  con- 
fining and  debilitating  character.    In  the  latter  class  of  candidates 
the  unusual  and  peculiar  services  that  would  necessarily  be  exacted 


12  PHYSICAL  EXAMINATION    OF   RECRUITS. 

of  them  might  develop  any  weakness  or  constitutional  physical  traits 
that  existed  prior  to  enlistment. 

2067.  While  it  is  not  expected  that  candidates  for  special  ratings 
should  possess  the  physique  and  endurance  of  those  actively  engaged 
in  strictly  military  duties,  the  examining  surgeon  should  remember 
that  all  candidates  examined  for  the  several  special  ratings  are  en- 
listed for  the  performance  of  all  duties  pertaining  to  the  naval  service 
ashore  and  afloat. 

2068.  The  examining  surgeon  should  consider  carefully  the  physi- 
ognomy of  the  candidate.     Where  the  applicant's  face  is  marked 
by  great  deformity,  warts,  or  extensive  birthmarks,  he  shall  be  con- 
sidered undesirable  for  the  service  and  shall  be  rejected. 

2069.  The  examining  surgeon  shall  exercise  the  greatest  care  in 
the  examination  of  the  candidate's  feet.     Pronounced  flat  foot,  loss 
or  deformity  of  the  large  toe,  or  of  two  of  the  smaller  toes  on  one 
or  both  feet,  partial  ankylosis  of  the  ankles,  marked  callosities  or 
ingrowing  toenails,  and  any  other  defects  which  in  the  opinion  of 
the  examining  surgeon  may  interfere  with  inarching  or  prolonged 
sentry  or  deck  duty  shall  be  considered  causes  for  rejection  of  the 
applicant. 

2070.  The  absence  of  or  the  marked  deformity  of  the  right  index 
finger  or  thumb  shall  cause  the  rejection  of  the  applicant.     The  im- 
portance attached  to  the  absence  of  or  deformity  of  the  left  index 
finger  or  thumb  will  depend  upon  the  adaptability  of  the  applicant 
for  his  special  rating,  and  provided  that  he  is  otherwise  physically 
sound. 

2071.  In  determining  the  weight  to  be  attached  to  slight  degrees 
of  varicocele,  varicose  veins,  and  hemorrhoids,  the  examining  sur- 
geon shall  carefully  consider  the  age,  the  general  physique,  and  the 
rating  of  the  applicant.     All  candidates  with  hydrocele  shall  be  re- 
jected, also  all  candidates  with  varicocele  when  accompanied   by 
atrophy  of  the  testes,  pain,  or  an  evident  neurotic  state. 

2072.  Marked  enlargement  in  either  testicle  or  the  absence  of  both 
testicles   shall   cause   the  rejection   of   the   applicant.     Applicants 
whose  clothing  exhales  the  odor  of  urine,  or  who  present  any  evi- 
dences of  incontinence  of  urine,  shall  be  rejected.    Cases  of  epispadias 
and  hypospadias  shall  be  rejected. 

2073.  Every  recruit  must  have  at  least  20  sound  teeth,  and  of  these 
not  less  than  4  opposed  incisors  and  4  opposed  molars ;  but,  if  other- 
wise qualified  and  desirable,  a  waiver  may  be  requested  in  the  case 
of  a  candidate  not  having  4  opposed  incisors  and  4  opposed  molars. 

2074.  The  examination  for  visual  acuteness  is  of  the  utmost  im- 
portance and  shall  be  conducted  by  the  medical  officer  with  the  great- 
est care  and  patience.     An  appreciable  percentage  of  men  are  the 
subjects  of  slight  visual  defects,  and  in  the  cases  of  many  of  those 
presenting  themselves  for  reenlistment  and  enlistment  these  defects 
may  not  be  sufficiently  serious  to  disqualify  them  for  the  naval 
service.    The  ignorance,  fear,  or  stupidity  on  the  part  of  an  applicant 
undergoing  examination  should  be  taken  into  consideration  by  the 
examining  surgeon,  and  unless  the  examination  is  conducted  with 
care  and  deliberation  an  applicant  may  be  rejected  whose  vision  is 
really  good.     Slight  errors  on  the  part  of  the  applicant,  such  as 
misreading  a  P  or  T  for  an  F,  provided  the  majority  of  the  letters 


PHYSICAL   EXAMINATION   OF   RECRUITS.  13 

or  test  characters  are  read  with  facility,  need  not  be  sufficient  cause 
for  rejection.  The  examination  shall  be  conducted  in  a  large  well- 
lighted  apartment,  and  the  test  cards  shall  be  placed  in  a  good  light. 
The  applicant  stands  at  a  distance  of  20  feet,  one  eye  being  tested 
at  a  time,  and  the  other  covered  by  a  card.  Vision  is  to  be  expressed 
as  a  fraction,  of  which  the  numerator  shall  be  the  distance  at  which 
Snellen's  20-foot  test  can  be  determined  and  the  denominator  20. 
Normal  vision  (20/20)  for  each  eye,  tested  separately,  shall  be  re- 
quired, but  in  candidates  who  are  otherwise  physically  sound  a  mini- 
mum visual  acuteness  of  15/20  shall  suffice.  The  existence  of  several 
minor  defects,  combined  with  a  visual  acuteness  of  15/20  in  each  eye, 
shall  cause  the  rejection  of  the  applicant. 

2075.  Color  perception  is  to  be  carefully  determined.    The  usual 
examination  is  by  Holmgren's  method,  which  may  be  briefly  de- 
scribed as  follows :  The  worsteds  are  placed  in  a  pile  in  the  center  of 
a  white  surface  in  good  daylight.     The  green  test  skein  is  placed 
aside  upon  the  white  cloth,  and  the  person  to  be  examined  is  directed 
to  select  the  various  shades  of  the  same  color  from  the  pile  and  place 
them  by  the  sides  of  the  sample.     The  color  blind  will  make  mistakes 
in  the  selection  of  the  shades ;  or  a  hesitating  manner  with  a  disposi- 
tion to  take  the  wrong  shades  may  show  a  feeble  chromatic  sense. 
The  purple  test  skein  is  then  used.     If  the  test  with  the  green  skein 
has  shown  the  person  examined  to  be  color  blind,  and  on  the  second 
or  purple  test  he  selects  only  the  purple  skeins,  he  is  incompletely 
color  blind ;  but  if  he  places  with  the  purple  shades  of  green  or  gray, 
he  is  completely  green  blind.     The  red  test  skein  need  not  neces- 
sarily be  used,  but  it  may  be  employed  to  confirm  the  diagnosis  al- 
ready made ;  for  the  red  blind  will  select,  to  match  the  red  skein, 
shades  of  green  or  brown  which  to  the  normal  sense  seem  darker 
than  the  red,  while  the  green  blind  will  select  the  shades  of  green 
or  brown  which  seem  lighter. 

2076.  The   organs   of   hearing,   both   the    conducting  apparatus 
(outer  and  middle  ear)  and  the  percipient  apparatus  (internal  ear) 
must  be  free  from  disease.     In  testing  the  hearing  of  the  applicant 
advantage  should  be  taken  of  the  absence  of  other  sounds  to  make 
the  examination.     Medical  officers  should  remember  that  the  appli- 
cant may  be  totally  deaf  in  one  ear  and  yet  may  hear  all  ordinary 
conversation  perfectly  if  the  sound  ear  is  not  completely  closed. 
Deafness  may  be  caused  by  an  accumulation  of  hardened  wax,  there- 
fore an  otherwise  desirable  recruit  should  have  his  ears  well  cleaned 
before  final  action  is  taken  in  his  case.     Hearing  shall  be  expressed 
as  a  fraction,  of  which  the  numerator  shall  be  the  distance  in  inches 
at  which  the  ticking  of  an  ordinary  watch  can  be  heard,  and  the 
denominator  40.     If  the  voice  is  used,  hearing  shall  be  expressed 
as  a  fraction,  of  which  the  numerator  shall  be  the  distance  in  feet  at 
which  the  voice  of  the  examiner  can  be  heard  and  the  denominator 
15.     The  voice  is  a  more  reliable  method  of  determining  the  acute- 
ness  of  hearing  than  the  watch  test,  as  it  allows  for  variations  in 
hearing  with  the  modifications  produced  by  changes  in  pitch  and 
tone.     Complete  deafness  in  either  ear  shall  be  considered  a  sufficient 
cause  for  rejection.     Before  completing  the  examination  the  medical 
officer  shall  satisfy  himself  of  the  patency  of  the  eustachian  tubes 
and  the  integrity  of  the  tympanic  membranes. 


14  PHYSICAL  EXAMINATION    OF   RECKUITS. 

2078.  In  every  case  of  rejection,  the  disability  unfitting  the  appli- 
cant for  service,  and  in  other  cases  any  abnormal  condition,  former 
grave  illness,  or  serious  injury  not  inconsistent  with  present  bodily 
vigor  shall  be  entered  on  Form  X  (rough). 

2079.  Recruits  presenting  themselves  for  enlistment  in  the  naval 
service  shall  be  rejected  by  the  examining  surgeon  for  any  one  of 
the  following  conditions: 

GENERAL,  DISQUALIFICATIONS. 

(a)  Mental  infirmities. — Insanity,  idiocy,  imbecility,  dementia. 

(b)  Moral  infirmities. — Intemperance  in  the  use  of  stimulants  or 
narcotics,  evidence  of  felony,  masturbation,  sodomy. 

(c)  Diseases  of  the  cerebrospinal  system. — Epilepsy,  chorea,  all 
forms  of  paralysis,  tabes  dorsalis,  neuralgia,  stuttering. 

(d)  Constitutional    diseases. — Feebleness    of    constitution     (poor 
physique),  syphilis. 

SPECIAL  DISQUALIFICATIONS. 

(e)  The  skin. — All  chronic,  contagious,  and  parasitic  diseases  of 
the  skin,  extensive  nevi,  deep  and  adherent  cicatrices,  chronic  ulcers, 
vermin. 

(/)  The  head. — Abnormally  large  head ;  considerable  deformities, 
the  consequence  of  fracture;  serious  lesions  of  the  skull,  the  conse- 
quence of  complicated  wounds  or  the  operation  of  trephining ;  caries 
and  exfoliation  of  the  bone,  injuries  of  cranial  nerves,  tinea  capitis, 
alopecia. 

(g)  The  spine. — Caries,  spina  bifida,  lateral  or  angular  curvatures 
of  the  cervical,  dorsal,  or  lumbar  regions;  lumbar  abscess,  rickets, 
fracture  and  dislocation  of  the  vertebrae,  angular  curvatures,  includ- 
ing gibbosity  of  the  anterior  and  posterior  parts  of  the  thorax. 

(h)  The  ears. — Deafness  of  one  or  both  ears,  all  catarrhal  and 
purulent  forms  of  acute  and  chronic  otitis  media,  polypi  and  other 
growths  or  diseases  of  the  tympanum,  labyrinth,  or  mastoid  cells; 
perforation  of  the  tympanum ;  closure  of  the  auditory  canal,  partial 
or  complete,  except  from  acute  abscess,  furuncle,  or  impacted  ceru- 
men ;  malformation  or  loss  of  the  external  ear  and  all  diseases  there- 
of, except  those  which  are  slight  and  nonprogressive. 

(i)  The  eye. — Loss  of  eye,  total  loss  of  sight  of  either  eye,  con- 
junctival  affections,  including  trachoma,  entropion ;  opacities  of  the 
cornea,  if  covering  a  part  of  a  moderately  dilated  pupil ;  pterygium, 
if  extensive ;  strabismus,  hydrophthalmia,  exophthalmia,  conical  cor- 
nea, cataract,  loss  of  crystalline  lens,  diseases  of  the  lachrymal  appa- 
ratus, ectropion,  ptosis,  incessant  spasmodic  motion  of  the  lids,  ad- 
hesion of  the  lids,  large  encysted  tumors,  abscess  of  the  orbit,  mus- 
cular asthenopia,  nystagmus.  Any  affection  of  the  globe  of  the  eye 
or  its  contents ;  defective  vision,  including  anomalies  of  accommoda- 
tion and  refraction ;  myopia,  hypermetropia,  if  accompanied  by  asthe- 
nopia, astigmatism,  amblyopia,  glaucoma,  diplopia,  color  blindness. 

(j)  The  face. — Extensive  nevi,  unsightly  hairy  spots,  extensive 
cicatrices  on  the  face. 

(k)  The  mouth  and  fauces. — Harelip,  simple,  double,  or  compli- 
cated ;  loss  of  the  whole  or  a  considerable  part  of  either  lip ;  unsightly 


PHYSICAL   EXAMINATION    OF   RECRUITS.  15 

mutilation  of  the  lips  from  wounds,  burns,  or  disease;  loss  of  the 
whole  or  part  of  either  maxilla,  ununited  fractures,  ankylosis,  deform- 
ities of  either  jaw  interfering  with  mastication  or  speech,  loss  of 
certain  teeth,  cancerous  or  erectile  tumors,  hypertrophy  or  atrophy 
of  the  tongue,  mutilation  of  the  tongue,  adhesion  of  the  tongue  to  any 
parts,  preventing  its  free  motion;  malignant  diseases  of  the  tongue, 
chronic  ulcerations,  fissures  or  perforations  of  the  hard  palate,  sali- 
vary or  bucconasal  and  thyroglossal  fistulre,  hypetrophy  of  the  ton- 
sils sufficient  to  interfere  with  respiration  or  phonation,  pyorrhoea. 

(1)  The  neck. — Goiter,  adenitis  of  the  cervical  glands,  tracheal 
openings,  thyroglossal  or  cervical  fistulse,  wry  neck,  chronic  laryn- 
gitis, or  any  other  disease  of  the  larynx  which  would  produce  apho- 
nia, stricture  of  the  esophagus. 

(m]  The  chest. — Malformation  of  the  chest,  or  badly  united  frac- 
tures of  ribs  or  sternum  sufficient  to  interfere  with  respiration ;  caries 
or  necrosis  of  ribs,  deficient  expansive  mobility,  evident  predisposi- 
tion to  tuberculosis,  chronic  pneumonia,  emphysema,  chronic  pleurisy, 
pleural  effusions,  chronic  bronchitis,  asthma,  organic  disease  of  the 
heart  or  large  arteries,  serious  protracted  functional  derangement  of 
the  heart. 

(n)  The  abdomen. — All  chronic  inflammations  of  the  gastroin- 
testinal tract,  including  diarrhea  and  dysentery ;  diseases  of  the  liver 
or  spleen,  including  those  caused  by  malarial  poisoning,  ascites, 
obesity,  dyspepsia,  if  confirmed;  hemorrhoids,  prolapsus  ani,  fistula 
in  ano,  considerable  fissures  of  the  anus,  hernia  in  all  situations. 

(o)  Genito-urinary  organs. — Any  acute  affection  of  the  genital 
organs,  including  gonorrhea,  syphilis,  and  venereal  sores ;  loss  of  the 
penis,  phimosis,  if  complete,  stricture  of  the  uretha,  loss  of  both  tes- 
ticles, undescended  testicle  or  permanent  retraction  of  one  or  both 
testicles,  chronic  disease  of  the  testicle  or  epididymitis,  hydrocele  of 
the  tunic  and  cord  unless  the  hydrocele  of  the  cord  is  small  and  in- 
consequent, atrophy  of  the  testicle,  varicocele,  malformations  of  the 
genitalia,  epispadias,  hypospadias,  but  a  slight  degree  of  hypospadias 
not  preventing  the  normal  passage  of  urine  may  not  cause  rejection; 
incontinence  or  retention  of  urine,  urinary  fistula,  enlargement  of 
the  prostate,  calculus,  cystitis,  and  all  organic  diseases  of  the  kidney. 

(p)  Affections  common  to  both  the  upper  and  lower  extremities. — 
Chronic  rheumatism,  chronic  diseases  of  joints  or  movable  cartilage, 
old  or  irreducible  dislocations  or  false  joints,  severe  sprains,  relaxa- 
tion of  the  ligaments  or  capsules  of  joints,  dislocations,  fistulse  con- 
nected with  joints  or  any  part  of  bones,  effusions  into  joints,. badly 
united  or  nonunited  fractures,  defective  or  excessive  curvature  of  the 
]ong  bones,  rickets,  caries,  necrosis,  exostoses,  atrophy  or  paralysis/>f 
a  limb;  extensive,  deep,  or  adherent  cicatrices,  especially  of  burns, 
contraction  or  permanent  retraction  of  a  limb  or  portion  thereof,  loss 
of  a  limb  or  portion  thereof,  inequality,  deformities. 

(q)  The  upper  extremities. — Fracture  of  the  clavicle,  fracture  of 
the  radius  and  ulna,  webbed  fingers,  permanent  flexion  or  extension 
of  one  or  more  fingers,  as  well  as  irremediable  loss  of  motion  of  these 
parts ;  mutilation  or  loss  of  either  thumb,  total  loss  of  the  index  finger 
of  the  right  hand,  loss  of  the  second  and  third  phalanges  of  all  fingers 
of  either  hand,  total  loss  of  any  two  fingers  of  the  same  hand. 

(r)  The  lower  extremities. — Varicose  veins,  knock-knees,  clubfeet, 
flat  feet,  webbed  toes,  the  toes  double  or  branching,  the  great  toe 


16 


PHYSICAL  EXAMINATION    OF   RECRUITS. 


crossing  the  other  toes,  hammertoe,  bunions,  corns,  overriding  or 
superposition  of  any  of  the  toes  to  an  extreme  degree,  loss  of  a  great 
toe,  loss  of  any  two  toes  of  the  same  foot,  permanent  retraction  of  the 
last  phalanx  of  any  of  the  toes,  or  flexion  at  a  right  angle  of  the  first 
phalanx  of  a  toe  upon  the  second,  with  ankylosis  of  the  articulation ; 
ingrowing  of  the  nail  of  the  great  toe,  bromidrosis. 

2080.  (a) — Table  of  physical  proportions  for  height,  weight,  and 
chest  measurement  of  adults. 

[Bureau  of  Navigation  Circular  relating  to  the  enlistment  of  men,  July  20,  1912.J 


Height. 

Weight. 

Chest 
(mean 
circum- 
ference). 

Inches. 

Pounds. 

Inches. 

64 

128 

33 

65 

130 

33 

66 

132 

33£ 

67 

134 

34 

68 

141 

84$ 

69 

148 

34} 

70 

155 

351 

71 

162 

36 

72 

169 

361 

73 

176 

36f 

— Table  of  physical  proportions  for  enlistment  of  Filipinos. 


Age. 

Height. 

Weight. 

Chest 
measure- 
ment 
(mean). 

Expansion. 

18  to  19 

61 

105 

301 

2 

20  to  21 

62 

108 

31 

21 

22  and 

62£ 

110 

31$ 

2| 

over. 

2081.  The  minimum  height  for  acceptance  of  a  man  21  years  old 
or  over  is  64  inches  barefooted.  A  variation  not  exceeding  1  inch  is 
permissible  if  the  applicant  is  in  good  health  and  desirable  as  a  re- 
cruit. The  minimum  weight  for  acceptance  of  a  man  21  years  old  is 
128  pounds.  A  variation  of  10  pounds,  not  to  fall  below  128  pounds 
in  weight  or  2  inches  in  chest  measurement  below  the  standard  given 
in  the  table  is  admissible  when  the  applicant  for  enlistment  is  active, 
has  firm  muscles,  and  is  evidently  vigorous  and  healthy,  except  for 
enlistment  in  the  rate  of  coal  passer,  for  which  rate  full  standard 
measurements  will  be  required.  A  chest  expansion  of  less  than  2 
inches  in  a  minor,  or  of  less  than  2J  inches  in  an  adult,  is  a  sufficient 


PHYSICAL   EXAMINATION    OF    RECRUITS. 


17 


cause  for  rejection  of  an  applicant.  The  table  is  given  to- show  what 
is  regarded  as  a  fair  standard  of  physical  proportions  and  not  as  an 
absolute  guide  to  be  followed  in  deciding  upon  the  acceptance  of  re- 
cruits. 

2082.  A  minor  enlisting  as  apprentice  seaman  must  conform  to  the 
standards  noted  in  the  following  table,  which  is  also  applicable  to 
apprentice  musicians,  United  States  Marine  Corps,  and  to  midship- 
men. (Circular  of  July  20,  1912.) 


Minimum 
height. 

Minimum 
weight. 

Chest 
expansion. 

At  17  years  of  a^e 

Inches. 
62 

Pounds. 
110 

Inches. 
2 

At  18  years  of  age 

64 

115 

2 

At  19  years  of  age  

64 

120 

2 

At  20  years  of  age  

64 

125 

2 

(If  the  age  is  6  months  in  excess  of  a  full  year  the  requirements  are 
those  of  the  age  at  the  next  birthday. ) 

(No  underweight  or  underheight  is  allowed  in  minors.) 

2083.  Marked  disproportion  of  weight  over  height  is  not  a  cause 
for  rejection  unless  the  applicant  is  positively  obese. 

2084.  Any  one  of  the  following  conditions  will  be  sufficient  to 
cause  the  rejection  of  an  applicant  (Bureau  of  Navigation  Circular, 
1916) : 

(a)  Feeble  constitution,  general  poor  physique,  or  impaired  gen- 
eral health. 

(b)  Any  disease  or  deformity,  either  congenital  or  acquired,  that 
would  impair  efficiency,  such  as:  Weak  or  deranged  intellect,  cuta- 
neous disease  not  of  a  mild  type,  parasites  of  the  skin  or  its  append- 
ages, deformity  of  the  skull,  abnormal  curvature  of  the  spine,  torti- 
collis, inequality  of  upper  or  lower  extremities,  inefficiency  of  joints 
or  limbs,  deformity  of  joints  or  bones  (either  congenital  or  the  re- 
sult of  disease  or  injury),  evidence  of  epilepsy  or  other  convulsions, 
defective  vision   (minimum  15/20  S.  in  either  eye),  disease  of  the 
eye,  color  blindness,  impaired  hearing  or  disease  of  the  ear,  chronic 
nasal  catarrh,  ozena,  polypi,  great  enlargement  of  the  tonsils,  impedi- 
ment of  speech,  disease  of  heart  or  lungs  or  predisposition  to  such 
disease,  enlarged  abdominal  organs  or  evidence  of  cirrhosis,  tumors, 
hernia,  undescended  testicle,  large  varicocele,  sarcocele,  hydrocele, 
stricture,  fistula,  hemorrhoids,  large  varicose  veins,  disease  of  the 
genito-urinary  organs,  chronic  ulcers,  ingrowing  nails,  bad  corns, 
large  bunions,  deformity  of  toes,  loss  of  many  teeth,  or  teeth  gen- 
erally unsound  (teeth  properly  filled  not  to  be  considered  unsound). 
Every  recruit  must  have  at  least  20  sound  teeth. 

(c)  Any  acute  disease. 

2085.  (a)  Each  recruit  shall  be  required  to  take  the  oath  of  alle- 
giance, and  further  state  that  the  statement  he  makes  regarding  his 
date  of  birth  and  previous  naval  or  other  military  service  is  correct, 
and  that  he  is  not  subject  to  fits,  has  no  disease  concealed  or  likely  to 
be  inherited,  and  has  no  stricture  or  internal  piles.    The  examining 

51677°— 16 3 


18  PHYSICAL   EXAMINATION    OF    RECRUITS. 

surgeon  certifies  on  the  service  record  as  follows:  "I  certify  that  I 
have  carefully  examined,  agreeably  to  the  Regulations  of  the  Navy, 
the  above-named  recruit,  and  find  that,  in  my  opinion,  he  is  free 
from  all  bodily  defects  and  mental  infirmity  which  would  in  any  way 
disqualify  him  from  performing  the  duties  of  his  rating,  and  that 
he  has  stated  to  me  that  he  has  no  disease  concealed  or  likely  to  be 
inherited." 

(b)  (1)  On  account  of  insufficient  or  inaccurate  information  in 
reports  of  rejection  as  to  physical  defects  of  applicants  for  enlist- 
ment, the  bureau  is  frequently  unable  to  determine  whether  such  de- 
fects should  be  waived,  and  such  reports  are  often  returned  for  fur- 
ther information  before  recommendation  can  be  made. 

(2)  When  a  defect  is  curable  by  minor  operation,  the  medical  ex- 
aminer should  so  state  and  also  whether  the  applicant  agrees  to 
operation  if  necessary. 

(3)  In  reporting  rejections  for  any  of  the  following  defects  the 
bureau  desires  that  the  information  as  noted  below  be  given : 

(4)  Flat  foot. — Give  degree  of  flatness,  stating  accurately  the  dis- 
tance between  the  tubercle  of  the  scaphoid  and  the  line  from  the 
lower  border  of  the  internal  malleolus  to  the  lowTer  tubercle  on  the 
head  of  the  first  metatarsus.     The  measurement  should  be  taken 
standing  with  the  weight  of  the  body  on  that  foot  and  when  the  foot 
is  at  a  right  angle  to  the  leg  and  the  second  toe  is  on  a  line  with  the 
crest  of  the  tibia.    The  size  of  the  shoe  should  also  be  given.    The 
width  of  the  ball  of  the  foot  should  be  given  and  any  tendency  to 
talipes  valgus  noted. 

(5)  Bunions,  hammertoes,  corns,  and  ingrowing  toenails  should 
be  described  accurately  as  to  location,  degree,  etc. 

(6)  Varicocele. — State  size   and  indicate  by  small,   medium,   or 
large. 

(7)  Varicose  veins. — State  location,  extent,  and  size  and  indicate 
by  small,  medium  or  large. 

(8)  Hemorrhoids. — State  character  and  size  and  indicate  by  small, 
medium,  or  large. 

(9)  Hydrocele. — State  size  and  indicate  by  small,  medium,   or 
large. 

(10)  Hernia. — State    location,    size,    and    whether   incipient,    in- 
complete, or  complete.    Relaxed  rings  only  are  not  cause  for  rejec- 
tion unless  abdominal  walls  are  weak  or  there  is  a  decided  impulse 
on  coughing. 

(11)  Deformities. — State  location,  character,  degree,  and  amount 
of  interference  with  motion. 

(12)  Contractures. — State  location,  degree,  and  amount  of  inter- 
ference with  motion. 

(13)  Stiff  joint. — State  location,  degree  of  flexion  and  extension 
obtainable  and  the  strength  of  the  part. 

(14)  Defective  hearing. — State  degree,  giving  distance  by  watch, 
by  the  whispered  and  spoken  voice,  stating  whether  he  can  readily 
hear  ordinary  conversation.     State  condition  of  the  external  canals 
and  drums. 

(15)  Defective  vision. — State  defect  accurately,  whether  due  to 
refractive  error  or  other  disease ;  when  practicable,  giving  correction 
by  lenses. 


PHYSICAL   EXAMINATION   OF   RECRUITS.  19 

(16)  Missing  or  defective  teeth. — State  in  detail  those  missing  or 
unerupted   and  those  defective,   using   diagram,   for  that  purpose. 
Also  state  whether  teeth  will  admit  of  proper  repair. 

(17)  Deficient  height  or  weight. — Always  state  age,  height,  and 
weight. 

(18)  Tachycardia. — State  cause,  character,  and  duration,  giving 
time  during  examination  for  applicant  to  recover  from  excitement 
or  overexertion. 

(19)  Spinal  curvature. — State  location,  character,  and  degree. 

(20)  Atrophy  or  ^hy  per  trophy  of^  testicle. — State  degree  and  cause. 

2086.  (a}  Recruits  shall  be  vaccinated  within  24  hours  after  their 
arrival  on  a  receiving  ship  or  at  a  barracks.    In  case  of  failure  the 
operation  shall  be  repeated  in  eight  days.    If  the  second  vaccination 
is  not  successful  it  shall  be  repeated  at  the  first  opportunity  with  a 
vaccine  of  assured  potency.     The  only  acceptable  evidence  of  suc- 
cessful vaccination  is  a  pitted  scar  following  vaccination.     Results 
of  vaccination  shall  be  recorded  on  the  health  record  and  reported  on 
the  quarterly  report  of  sick. 

(b)  No  recruit  in  the  Navy.or  Marine  Corps  shall  be  transferred 
from  a  training  station,  receiving  ship,  barracks,  or  other  rendez- 
vous until  the  medical  officer  is  satisfied  that  the  man  is  protected 
against  smallpox. 

(c)  Every  enlisted  man  of  the  Navy  or  Marine  Corps  shall  be 
vaccinated  upon  reenlisting,  or  extending  enlistment,  unless  (a)  he 
has  two  pitted  vaccination  scars,  or  (b)  shows  evidence  of  a  previous 
attack  of  smallpox. 

(d)  Every  officer  should  be  vaccinated  upon  appointment  imme- 
diately upon  reporting  at  his  first  station  for  duty,  and  the  fact  en- 
tered on  his  health  record.     Eevaccination  should  be  performed  at 
least  once  in  every  seven  years  thereafter  unless  he  has  two  pitted 
vaccination  scars,  or  evidence  of  a  previous  attack  of  smallpox.    The 
responsibility  for  revaccination  shall  rest  upon  the  medical  officer 
making  the  annual  physical  examination  required  by  I  709  (5).    If 
it  is  impracticable  for  this  medical  officer  to  perform  the  vaccination, 
he  shall  notify  the  proper  medical  officer,  through  official  channels,  so 
that  it  may  be  carried  out.     The  medical  officer  who  performs  the 
vaccination  shall  note  the  result  of  the  vaccination  on  the  officer's 
health  record.     (I  3211.) 

2087.  (a)  Typhoid  prophylactic  shall  be  administered  to  all  per- 
sons upon  their  first  entry  into  the  Navy  or  Marine  Corps. 

(&)  It  shall  be  administered  to  each  enlisted  man  upon  each  subse- 
quent enlistment,  or  extension  of  enlistment,  who  is  under  45  years 
of  age,  or  who  has  not  had  a  well-defined  case  of  typhoid  fever.  The 
medical  officer  making  the  physical  examination  at  the  time  of  re- 
enlistment  shall  start  the  administration,  if  practicable;  if  not,  he 
shall  notify  the  proper  medical  officer,  through  official  channels,  so 
that  the  administration  may  be  completed. 

(c)  The  administration  of  typhoid  prophylaxis  should  be  repeat- 
ed after  a  period  of  four  years  for  all  persons  in  the  Navy  or  Marine 
Corps  who  are  under  45  years  of  age,  or  who  have  not  had  a  well- 
defined  case  of  typhoid  fever,  and  the  medical  officer  making  the 
annual  physical  examination  required  by  Article  I  709  (5)  shall  be 
responsible  for  its  administration.  If  it  is  impracticable  for  him  to 


20  PHYSICAL   EXAMINATION    OF   RECRUITS. 

give  the  prophylactic,  he  shall  notify  the  proper  medical  officer, 
through  official  channels,  so  that  it  may  be  given. 

(d)  The  only  acceptable  evidence  of  administration  of  the  proph- 
ylactic shall  be  the  entry  on  the  health  record,  signed  by  the  medical 
officer.  (I  3212.) 

2088.  Medical  officers  are  required  by  act  of  February  16,  1914,  to 
conduct  a  physical  examination  of  men  of  the  Naval  Militia  when 
mustered  into  service  of  the  United  States.     (General  Order  No.  150, 
June  14, 1915.) 

2089.  When  available,  medical  officers  will  make  such  examina- 
tions of  members  of  the  Naval  Auxiliary  Service  as  are  prescribed  in 
the  regulations  for  that  service. 


SUPPLEMENTARY  NOTES  ON  RECRUITING. 

Whenever  health  records  or  reports  of  medical  surveys  represent 
a  disability  to  have  existed  prior  to  enlistment,  the  fact  shall  be 
reported  to  the  Bureau  of  Medicine  and  Surgery;  and  the  medical 
officer  who  passed  such  recruit  shall  be  held  accountable  for  the 
improper  enlistment.  (I  3204.)  The  examination  having  been  con- 
cluded, and  the  candidate  found  qualified  for  the  service,  the  medical 
examiner  shall  enter  his  descriptive  list  upon  the  blank  records 
furnished  by  the  Bureau  of  Navigation  or  the  commandant  of  the 
Marine  Corps,  and,  having  signed  it,  shall  transmit  the  record  to  the 
commanding  officer  of  the  ship^  station,  rendezvous,  or  post.  Upon 
the  transfer  at  any  time  of  an  enlisted  person  the  medical  officer  shall 
make  the  necessary  entries  upon  the  health  records. 

Relaxed  inguinal  rings  alone  should  not  be  considered  a  cause  for 
rejection,  unless  there  is  plain  evidence  of  weakness  of  the  abdominal 
walls  and  a  decided  impulse  on  coughing.  (Par.  2085,  Manual  for 
the  Medical  Department,  1914.)  A  condition  of  patulous  rings,  how- 
ever, should  be  noted  by  the  medical  officer,  but  a  request  for  waiver 
is  not  considered  necessary. 

In  the  cases  of  men  suffering  from  minor  disqualifications  that 
can  be  remedied  by  operation  it  is  important  that  the  candidate 
should  state  his  willingness  to  be  operated  upon  if  the  condition 
should  later  result  in  a  disability,  but  this  should  not  be  interpreted 
to  mean  that  the  applicant  should  be  enlisted  with  a  view  that  he 
will  be  immediately  operated  upon  for  the  removal  of  his  disqualifi- 
cation. In  the  adjudication  of  pension  claims  it  has  been  decided 
that  disability  due  to  an  operation  upon  a  soldier  for  the  cure  of  piles 
by  a  surgeon  under  whose  charge  he  was  during  military  service  is 
pensionable,  notwithstanding  that  said  piles  existed  prior  to  enlist- 
ment. Similar  decisions  have  been  made  in  the  cases  of  other  dis- 
abilities under  like  circumstances,  where  a  disqualification  at  the  time 
of  enlistment  has  resulted  in  a  later  disability. 

In  making  recommendation  with  regard  to  defective  teeth  it  is 
advisable  to  consider  the  general  nutrition  of  the  applicant,  and 
a  waiver  should  not  be  requested  if  the  applicant  is  markedly  below 
the  weight  requirements. 

External  hemorrhoids  should  always  be  noted,  but  where  the 
medical  officer  considers  that  they  would  not  result  in  disability, 
waiver  should  be  requested.  In  the  past  10  years  there  have  been 

21 


22  PHYSICAL  EXAMINATION    OF   RECRUITS. 

only  52  discharges  from  the  service  for  disability  on  account  of 
hemorrhoids. 

It  is  generally  believed  and  has  been  so  expressed  in  articles  written 
on  the  subject  that  the  scaphoid  tubercle  is  not  normally  depressed 
over  one-half  inch.  The  Bureau  of  Medicine  and  Surgery  has,  how- 
ever, for  some  time  considered  waivers  of  men  for  enlistment  in  which 
the  depression  has  been  greater  than  one-half  inch  and  the  medical 
officer  and  recruiting  officer  considered  the  applicant  a  proper  can- 
didate for  enlistment.  It  is  not  considered  that  the  footprint,  or 
the  depression  of  the  scaphoid  tubercle,  are  as  important  in  judging 
the  degree  of  weak  foot  as  the  range  of  motion  of  the  foot,  and 
particularly  any  limitation  of  adduction.  Statistics  show  that  flat 
foot  is  one  of  the  most  frequent  causes  of  disability,  and  in  view  of 
the  act  of  March  3,  1885,  which  provides  "  That  all  applicants  for 
pension  shall  be  presumed  to  have  had  no  disability  at  the  time  of 
enlistment,  but  such  presumption  may  be  rebutted,"  it  is  considered 
advisable,  when  the  depression  of  the  scaphoid  tubercle  is  over  one- 
half  inch,  that  a  note  be  made  of  this  fact  and  a  waiver  requested. 

The  bureau  considers  that  there  are  many  good  reasons  why  waivers 
should  be  requested  in  the  cases  of  candidates  for  enlistment  who  fall 
below  the  table  of  physical  proportions,  not  only  on  account  of  the 
law  quoted  above,  but  in  order  that  the  recruit  depot  or  training 
station  may  know  that  the  applicant's  physical  qualifications  have 
been  fully  considered. 

Yaricocele  of  any  size  should  be  noted  in  the  enlistment  record. 
It  is  not  considered  advisable,  under  ordinary  circumstances,  to  recom- 
mend waiver  in  cases  where  the  varicocele  is  larger  than  the  testicle. 
It  has  been  found  at  recruit  depots  and  training  stations  that  men 
with  large  varicoceles  make  poor  recruits;  that  after  operation  con- 
siderable induration  frequently  results,  and  the  man  has  to  be  ex- 
cused from  drills,  etc.,  for  a  large  part  of  his  time  at  the  recruit 
depot  or  training  station,  often  ultimately  being  discharged  for 
disability. 

Atrophy  of  one  testicle  should  not  be  considered  a  cause  for  rejec- 
tion, but  should  be  noted  on  the  enlistment  record. 


OPENING  AND  PREPARING  HEALTH  RECORDS. 

[From  chap.  13,  Manual  for  the  Medical  Department.] 
NAVY  REGULATIONS  RELATING  TO  HEALTH  RECORDS. 

2201.  Patients  transferred  to  have  health  records.     R  2961   (2)  ; 
R  3585  (l)a. 

2202.  Entry  to  be  made  in  health  record  of  men  examined  before 
transfer.     R  2961  (3)  ;  R  3581  (5). 

2203.  Date  of  transfer  to  other  than  a  naval  hospital  to  be  noted 
in  health  record.     R  2962  (1). 

2204.  Health  records  of  patients  left  in  foreign  hospitals  to  be  left 
with  consul.     R  2962  (2). 

2205.  Health  record  continued  by  medical  officer  of  any  ship  ar- 
riving in  port.     R  2962  (3). 

2206.  Junior  medical  officer  to  keep  health  records.     R  2977;  I 
3251. 

2207.  Not  in  line  of  duty  entries,  on  health  record.    R  2902  (1-5). 

2208.  Disabilities  of  men  enlisted  to  be  entered  on  health  records. 
(I  3209);  R  3523  (3). 

2209.  Accidents  and  injuries  occurring  in  absence  of  medical  offi- 
cer to  be  noted  on  health  record.     R  4563. 

2210.  Disposition  of  health  records  of  paymaster's  clerks  upon 
termination  of  appointment.     R  3318  (7). 

NAVAL  INSTRUCTIONS  RELATING  TO  HEALTH  RECORDS. 

2211.  Custody  of  officers'  health  records.    I  708  (1). 

2212.  Every  officer  required  to  notifv  medical  officer  of  transfer. 
I  708  (2). 

2213.  Health  records  to  senior  officer  of  board  for  physical  exami- 
nation.    I  708  (3). 

2214.  Health  records  upon  completion  of  examination.    I  708  (4). 

2215.  Health  records  where  no  medical  officer.    I  708  (5). 

2216.  Officer  on  duty  where  no  medical  officer  to  furnish  reports 
of  disability.     I  708  (6). 

2217.  Periodical  physical  exercises.    I  709. 

2218.  Entries  in  health  records  indicating  use  of  intoxicants,  etc. 
I  707  (5). 

2219.  Health  records  to  be  inspected  by  fleet  surgeon.    I  1122  (2). 

2220.  Health  records  to  be  verified.    I  2102. 

2221.  Health  records  of  patients  received  for  passage.    I  2116. 

2222.  Medical  officers  shall  keep  health  records.    I  2117  (1). 

2223.  Completed  records  to  go  to  Bureau  of  Medicine  and  Sur- 
gery.    I  2117  (2). 

2224.  Commanding  officer  to  inspect  health  records.    I  2619  (2). 

2225.  Entries  upon  enlistment  and  transfer.    I  3208  (1-2). 

23 


24  PHYSICAL  EXAMINATION    OF   RECRUITS. 


.  Record  of  vaccination  to  be  entered  on  health  record.     I 
3211  (1). 

2227.  Administration  of  typhoid  prophylaxis  to  be  entered  on 
health  record.     I  3212. 

2228.  Health  records  at  hospitals  to  be  examined  weekly.    I  3226. 

2229.  Patients  upon  admission  to  hospitals  to  have  health  records. 
I  3229. 

2230.  Health  records  to  be  signed  and  verified.    I  3237. 

2231.  Care  in  keeping  health  records.    I  3252. 

2232.  Health  records  to  be  opened  upon  appointment  or  promo- 
tion of  officer.     I  3257. 

2233.  Examination  of  enlisted  men  for  rating  of  fireman  or  coal 
passer  to  be  entered   on  health   records.     (Letter  Nay.   2158-249, 
Feb.  24,  1912.) 

2234.  Records  of  physical  examinations  of  officers  for  periodical 
physical  exercise  in  January  to  be  made  in  health  records.     I  709 
(5);  I  708  (3). 

INSTRUCTIONS  TO  BE  OBSERVED  IN  OPENING  AND  PREPARING  HEALTH 

RECORDS. 

2241.  (a)  The  whole  name  (Christian,  middle,  and  surname),  to 
correspond  with  that  on  service  record  and  to  be  legibly  written  out, 
without  abbreviations,  and  correctly  spelled,  preference  being  given 
to  the  original  spelling  of  foreigners'  names,  the  surname  to  precede 
and  to  be  distinguished  by  being  underlined. 

(b)  As  far  as  possible,  on  reports  and  returns,  the  grades  and 
rates  of  officers  and  men  should  be  spelled  out  in  full,  but  where 
sufficient  space  is  not  provided  the  abbreviations  in  par.  2241  (b)  of 
the  manual  should  be  used. 

Enter  the  rating  in  which  actually  enlisted. 
Enter  the  name  of  the  place  where  enlisted. 

e)  Enter  date  actually  enlisted  and  strike  out  the  term  not  to  be 
used  as  not  applying  in  the  case  of  the  man  under  consideration, 
following  the  date  of  enlistment. 

(/)  Enter  month,  day,  and  year  of  birth. 

(g)  Specify  city,  town,  or  other  locality  of  birth,  whatever  the 
nationality. 

(h)  Enter  (from  recruit's  statement)  all  former  diseases  and 
injuries. 

(i)  Give  former  occupation  or  occupations. 

(j)  For  enlisted  persons  give  the  number  of  continuous-service  cer- 
tificate and  years  of  previous  service. 

k)  Give  name  and  address  of  nearest  relative  or  friend. 
I)  Enter  religion. 

m)  Eyes  :  Blue,  gray,  blue-gray,  yellow-gray,  hazel  (light  brown)  , 
dark  brown,  bicolored  (as  when  the  pupillary  border  is  of  a  different 
color  from  rest  of  iris)  ;  also  state  when  the  two  eyes  are  of  different 
colors. 

(n)  Hair:  Flaxen,  sandy  (yellowish  red),  auburn  (reddish  brown). 
brown  (light,  dark,  or  very  dark),  black;  also  whether  thin,  bald. 
straight,  curly,  or  woolly. 


PHYSICAL   EXAMINATION   OF   RECRUITS.  25 

(o)  Complexion  is  not  to  be  described  as  simply  "  light "  or  "  dark," 
but  the  character  and  degree  shall  be  as  accurately  stated  as  possible; 
as  complexion,  pallid,  sallow,  fair  (only  when  decidedly  clear), 
ruddy,  florid,  dark  (tawny,  sunburnt,  or  tanned),  very  dark  (swarthy 
or  dusky),  mulatto,  negro. 

(p)  Height  to  be  expressed  in  inches;  the  body  to  be  erect,  the  chin 
neither  elevated  nor  depressed,  the  feet  and  knees  touching,  legs  stiff, 
and  arms  hanging  perpendicularly. 

(q)  Weight,  body  nude,  or  allowance  made  for  clothing  worn. 
Accuracy  of  scales  to  be  ascertained  before  using. 

(r)  Vision  to  be  expressed  as  a  fraction,  of  which  the  numerator 
will  be  the  distance  at  which  Snellen's  20-foot  test  can  be  determined, 
and  the  denominator  20. 

(s)  Hearing  is  to  be  expressed  as  a  fraction,  of  which  the  numera- 
tor will  be  the  distance  in  feet  a  whispered  voice  can  be  heard,  and  the 
denominator  15. 

(t)  Circumference  of  thorax  to  express  the  mean  of  the  greatest 
circumference  after  forced  inspiration  and  of  the  least  after  forced 
expiration,  measured  by  a  tapeiine  horizontally  at  the  precise  level 
of  the  nipples ;  the  difference  between  the  greatest  and  least  circum- 
ference to  be  entered  as  expansion. 

(u)  Teeth  missing  or  useless  shall  be  indicated  by  marking  the 
dental  formula  as  noted. 

(v)  Remarks:  Note  any  prominent  physical  trait  not  inconsistent 
with  bodily  vigor  or  not  in  such  degree  as  to  constitute  cause  for 
rejection — leanness  or  the  reverse;  hirsuteness;  slight  asymmetry 
of  body  or  limbs,  knock- knees,  bowlegs,  or  flat  feet;  peculiarities  of 
teeth  and  genitalia;  slight  varicocele,  etc.  In  this  connection  exam- 
iners are  to  remember  that  imperfections  that  might  pass  in  a  man 
should  reject  boys. 

(w)  Marks  and  scars  should  be  indicated  as  required  on  the  printed 
outline  figure. 

(x]  Enter  the  date  and  nature  of  any  waiver  requested. 

(y}  Finally  sign  the  record  in  the  space  provided.  Corrections 
made  subsequent  to  enlistment  to  be  entered  in  red  ink  and  initialed. 

224:2.  This  record  shall  be  prepared  for  each  officer  and  enlisted 
man  of  the  Navy  and  Marine  Corps  and  for  members  of  the  Nurse 
Corps. 


IDENTIFICATION  RECORDS  AND  FINGER  PRINTS. 

Identification  records,  consisting  of  finger  prints  and  personal 
descriptions,  will  not  hereafter  be  forwarded  to  the  Bureau  of  Navi- 
gation upon  the  reenlistment  of  men  if  the  date  of  last  enlistment 
was  subsequent  to  January  1,  1907,  or  upon  discharge  for  undesira- 
bility,  bad  conduct,  or  with  dishonorable  discharge  if  enlisted  subse- 
quent to  that  date. 

The  files  of  finger  prints,  which  were  inaugurated  January  1, 1907, 
are  now  practically  complete  for  the  term  of  enlistment  provided  by 
law,  and  in  future  it  will  only  be  necessary  to  forward  finger  prints 
and  personal  descriptions  in  the  following  cases : 

On  first  enlistment. 

On  reenlistment  from  the  Army  or  Marine  Corps. 

On  reenlistment  when  date  of  last  enlistment  was  prior  to  January 
1, 1907. 

Upon  discharge  as  undesirable  or  wTith  bad  conduct  or  dishonorable 
discharge  if  the  enlistment  occurred  prior  to  January  1,  1907. 

In  future  it  will  only  be  necessary  to  forward  identification  records 
in  the  following  cases  to  headquarters,  United  States  Marine  Corps ; 

Upon  application  for  first  enlistment. 

Upon  reenlistment  from  Army  or  Navy. 

Upon  reenlistment  from  the  Marine  Corps  when  date  of  last  enlist- 
ment was  prior  to  January  1, 1908. 

Upon  discharge  as  undesirable  or  with  bad  conduct  or  dishonorable 
discharge  if  the  enlistment  occurred  prior  to  January  1,  1908. 

Identification  records  will  not  hereafter  be  forwarded  upon  the 
reenlistment  of  men  if  the  date  of  last  enlistment  was  subsequent  to 
January  1, 1908. 

OUTLINE  FIGURE   CARD  AND   DESCRIPTIVE   LIST. 

[From  chap.  12,  Manual  for  the  Medical  Department.].- 

2101.  The  outline  figure  on  the  reverse  side  of  the  finger-print 
record  shall  be  filled  out  in  the  case  of  every  recruit  that  has  been 
found  physically  qualified  and  accepted  for  enlistment  and  for  every 
sailor  or  marine  who  presents  himself  for  reenlistment  when  date 
of  last  enlistment  was  prior  to  January  1,  1907. 

2102.  Medical  officers  on  recruiting  duty  shall  observe  the  greatest 
care  in  the  preparation  of  these  cards  and  shall  exercise  every  care 
that  the  record  on  each  card  may  be  complete. 

27 


28 


PHYSICAL  EXAMINATION    OF   RECRUITS. 


2103.  The  medical  officer  shall  make  a  careful  and  systematic 
examination  of  the  body  of  the  man,  front  and  rear,  on  each  side  of 
the  median  line,  separately,  commencing  at  the  scalp  and  ending  at 
the  foot,  and  the  following  directions  shall  be  carefully  noted : 

(a)  Cards  showing  less  than  five  marks  in  addition  to  vaccination 
scars,  tattooing,  loss  of  teeth,  and  deformities  (which  should  like- 
wise be  noted)  can  not  be  relied  upon  in  the  effort  to  discover  identity 


or  to  identify  a  person  in  suspected  cases.     Experience  shows  that 
as  many  as  10  or  15  marks  may  usually  be  found. 

(b)  If  no  marks  be  found  upon  the  recruit,  the  fact  should  be 
stated  upon  both  the  front  and  back  of  the  card.    If  marks  are  found 
upon  the  front  and  none  upon  the  rear,  or  vice  versa,  the  entry  "  no 
mark  "  should  be  made  upon  the  appropriate  side  of  the  card. 

(c)  Outline  figure  cards  are  to  be  made  out  in  permanent  black 
ink.    Copying  ink  or  indelible  pencils  should  not  be  used. 


PHYSICAL   EXAMINATION   OF   RECRUITS.  29 

(d)  Name. — Christian  and  middle  name  in  full  and  surname  in  the 
order  to  be  used.    The  name  should  be  written  very  plainly,  or  pref- 
erably typewritten  or  printed  in  plain  gothic  letters. 

(e)  Rate. — The  rate  in  which  recruit  is  enlisted  shall  always  be 
stated. 

(/)  Age. — The  age  at  the  time  the  card  is  prepared  is  the  one  that 
shall  be  given. 

(g)  Height. — The  height  is  to  be  given  in  inches,  and  as  it  is  re- 
lied upon  as  a  base  in  comparing  the  cards  of  recruits  with  the 
classified  descriptions  of  the  former  sailors  or  marines,  and  as  the 
measurement  may  to  a  considerable  degree  be  affected  by  efforts  at 
deception  on  the  part  of  the  recruit,  great  care  in  ascertaining  it  is 
enjoined. 

(h)  Hair. — The  scale  of  hair  colors  may  be  given  as  follows :  Flax 
color ;  light  brown ;  of  red  hair,  as  follows :  brick  red,  sandy  red, 
auburn (  reddish  brown)  ;  dark  brown;  black;  of  gray  hair,  as  fol- 
lows: dark  gray,  light  gray  (approaching  white),  iron  gray  (mixed). 

(i)  Eyes. — The  eyes  should  be  compared  by  placing  the  subject 
with  the  face  in  good  light.  'Slide  the  Standard  Eye  Chart  up  or 
down  the  left  side  of  the  face,  close  to  the  left  eye.  The  nearest  ap- 
proach in  similarity  of  color  is  the  number  to  be  given.  If  the  right 
eye  is  distinctly  different  in  color,  its  number  also  should  be  given. 

(J)  White  or  colored. — Write  the  word  "white"  or  "colored"  to 
indicate  race  as  the  case  requires.  Do  not  indicate  by  crossing  out 
one  of  the  words. 

(/»•)  Date  of  last  prior  enlistment  in  the  Navy  or  Marine  Corps. — • 
If  the  recruit  has  had  no  prior  service  in  the  Navy  or  Marine  Corps, 
write  the  word  "  none." 

(I)  Missing  teeth. — To  indicate  the  missing  or  useless  teeth,  mark 
with  an  X  the  letters  corresponding  to  the  teeth  that  are  absent  or 
useless.  Teeth  that  are  partly  decayed  should  be  indicated  by  draw- 
ing a  diagonal  line  through  the  corresponding  letters.  If  none  are 
missing,  write  the  word  "  no  "  in  front  or  above  the  words  "  missing 
teeth."  This  will  show  that  they  were  not  overlooked. 

(m)  'Station  and  date. — Write  the  name  of  the  station  at  which  the 
card  is  made  out  and  the  date  of  its  preparation. 

2104.  Marks  on  the  outline-figure  card  should  be  made  at  points 
corresponding  to  those  occupied  by  the  marks  on  the  body  of  the  re- 
cruit. This  may  readily  be  accomplished  by  drawing  imaginary  lines 
on  the  body  of  the  recruit  like  the  dotted  lines  on  the  card  and  plac- 
ing the  mark  in  the  proper  position  on  the  card.  As  the  dotted  lines 
mark  the  boundaries  of  regions  which  are  used  in  the  systematic 
arrangement  of  the  cards  for  purposes  of  identification,  it  is  im- 
portant that  each  mark  on  the  card  should  be  placed  in  its  proper 
position. 

(a)  A  pen  picture  is  desired  of  all  marks,  showing  their  inclina- 
tion and  general  shape.  In  the  case  of  tattoos,  this  is  optional. 

(jb)  A  straight  line  should  be  drawn  from  each  mark  to  its  de- 
scription  on  the  right  or  left  of  the  figure.  Wlien  avoidable,  these 
lines  should  not  cross  each  other. 

(c)  When  a  description  is  common  to  a  number  of  marks,  it  need 
not  be  repeated  for  each  one,  but  the  lines  may  converge  to  it,  if 
they  can  do  so  without  crossing  others. 


30  PHYSICAL  EXAMINATION   OF   RECRUITS. 

(d)  The  sizes  of  all  scars,  moles,  warts,  birthmarks,  etc.,  are  to  be 
given  in  inches  or  fractional  parts  thereof,  except  in  the  case  of 
pinhead  moles  (abbreviation  p.  m.). 

(e)  Pinhead  moles  are  moles  less  than  one-eighth  of  an  inch  in 
diameter. 

(/)  Tattoo  marks  should  invariably  be  noted  and  described  in  de- 
tail as  they  appear.  In  the  case  of  devices  composed  of  two  or  more 
figures,  the  component  parts  should  be  named,  e.  g.,  "heart,  cross, 
and  anchor,"  not  "  faith,  hope,  and  charity  " ;  "  clasped  hands,"  not 
"  friendship " ;  "  eagle,  shield,  crossed  cannon,  flags,  and  arrows," 
not  "American  coat  of  arms."  The  same  applies  to  all  emblems,  coats 
of  arms,  lodge  pins,  badges,  etc. 

(g)  Letters,  initials,  and  words  should  be  printed,  by  hand,  in  plain 
roman  capitals  or  gothic,  thus:  "  J.  M.  H.,"  "U.  S.  V.,"  "I.  X.  L.," 
« IN  GOD  WE  TRUST,"  etc. 

(h)  Details  of  costume,  posture,  and  relationship  to  other  de- 
vices should  be  given  in  the  case  of  tattooed  representations  of  men 
and  women,  e.  g.,  "  woman  clinging  to  a  cross " ;  "  man  and  woman 
embracing,  houses,  lighthouse,  and  ship  in  the  background  " ;  "  sailor 
standing  by  a  tombstone,  weeping  willow  overhead,  cap  in  right 
hand,  words  '  in  memory  of  my  mother '  on  stone." 

(*)  The  size  of  tattoos  need  be  given  only  in  the  case  of  dots, 
blotches,  circles,  lines,  etc. 

(j)  It  is  not  necessary  to  state  the  color  or  kind  of  pigment  used  in 
the  tattooing. 

(k)  Do  not  crowd  the  description  of  tattoos  between  the  right  arm 
of  the  figure  and  the  edge  of  the  card  in  front,  nor  the  left  arm  and 
edge  of  the  card  on  the  back. 

(I)  Indecent  or  obscene  tattooing  is  cause  for  rejection,  but  the 
applicant  should  be  given  an  opportunity  to  alter  the  design,  in 
which  event  he  may,  if  otherwise  qualified,  be  accepted. 

(m)  Do  not  write  on  the  figure.  The  figure  is  to  be  used  only 
for  the  purpose  of  locating,  by  pen  pictures,  the  different  marks 
found  on  the  body  of  the  recruit. 

(n)  Amputations  and  losses  of  parts  of  fingers  and  toes  should 
be  noted,  showing  the  particular  member  injured  and  how  much  of 
it  is  gone. 

2105.  The  following  abbreviations  are  authorized  and  will  be 
understood  in  the  sense  indicated,  viz:  Amp.,  amputation;  bl.,  blue; 
bmk.,  birthmark;  bro.,  brown;  d.,  depressed  (except  when  following 
a  dimension;  then  it  stands  for  diameter);  f.,  flat;  fl.,  fleshy;  h., 
hairy;  m.,  mole;  p.,  pitted;  p.  m.  pinhead  mole;  r.,  raised;  s.,  scar 
or  smooth;  v.,  vaccination;  var.,  varicose  veins  or  varicocele;  w., 
wart. 

(a)  All  combinations  of  these  abbreviations  are  admissible,  e.  g., 
p.  s.  -|  d.,  pitted  scar  one-half  inch  in  diameter;  s.  1,  scar  1  inch  long; 
f.  p.  s.  1  x  -|,  an  oval,  flat,  pitted  scar,  1  inch  long  and  J  inch  wide. 

(&)  Abbreviations  denoting  shape  are  unnecessary,  for  the  letter 
"  d "  following  a  dimension  shows  that  the  mark  is  circular.  Two 
dimensions  given  indicate  that  the  mark  is  oval  or  oblong,  and  when 
no  letter  follows  the  dimension  it  is  understood  that  the  mark  or 
scar  is  linear. 


PHYSICAL   EXAMINATION   OF   BECKUITS.  31 

(c)  When  a  linear  mark  or  scar  is  otherwise  than  straight  the 
length  to  be  given  is  the  shortest  distance  from  one  extreme  to  the 
other. 

(d)  The  letters  "T.  M."  should  not  be  used  as  abbreviations  for 
"  Tattoo  marks,"  as  they  are  liable  to  be  taken  for  tattooed  letters  on 
the  person. 

FINGER  PRINTS. 

The  apparatus  for  taking  finger  prints  consists  of  a  form  holder, 
an  ink  plate,  and  a  roller  for  spreading  the  ink  on  the  plate. 

Keep  the  roller  and  ink  plate  clean  and  free  from  dust,  grit,  or 
hairs,  and  the  ink  tube  closed  when  not  in  use.  When  the  day's  work 
is  finished,  clean  the  ink  from  the  plate  and  roller  by  means  of  a  cloth 
and  benzine.  When  not  using  the  roller,  rub  it  with  a  little  sweet 
oil  or  lubricating  oil  before  laying  it  away,  to  prevent  the  composi- 
tion from  becoming  too  hard. 

Preparatory  to  taking  finger  prints  squeeze  a  small  quantity  of  ink 
from  the  tube  and  carefully  work  it,  by  use  of  the  roller,  into  a  thin 
film  on  the  plate,  the  spreading  of  which  may  be  facilitated  by  fre- 
quently turning  over  the  roller.  //  too  much  ink  is  used,  the  impres- 
sion will  ~be  blurred  and  consequently  unsatisfactory.  The  thickness 
of  the  ink  after  being  spread  on  the  plate  should  be  less  than  one-half 
the  elevation  of  the  ridges,  and  this  can  be  tested  by  taking  impres- 
sions. 

The  recruit  should  wash  his  hands  thoroughly  with  soap  and  brush, 
using,  if  practicable,  running  water,  especial  care  then  being  taken 
to  rinse  off  all  soap  or  lather  with  cold  water.  (Fig.  1.)  Failure  to 
do  this  will  cause  white  blotches  to  appear  in  the  impressions.  Imme- 
diately before  placing  the  fingers  on  the  inked  plate  the  fingers  should 
be  well  wiped  with  a  cloth  dampened  with  benzine  or  ether,  which 
should  remove  all  trace  of  grease,  water,  or  perspiration. 

Two  kinds  of  impressions  are  used,  "  plain  "  and  "  rolled."  A  plain 
impression  is  obtained  by  pressing  the  bulb  of  the  finger,  with  the 
plane  of  the  nail  parallel  to  the  plane  of  the  plate,  on  the  inked  plate 
and  then  on  the  paper  in  the  same  manner.  A  rolled  impression  is 
obtained  by  placing  the  side  of  the  finger  on  the  inked  plate,  with 
the  plane  of  the  nail  at  right  angles  to  the  plane  of  the  plate,  and 
rolling  the  finger  over  from  one  side  to  the  other  until  the  plane  of 
the  nail  is  again  at  right  angles  to  the  plane  of  the  plate,  but  with  the 
bulb  surface  of  the  finger  facing  in  the  opposite  direction,  thus  inking 
the  surface  of  the  finger,  and  then  rolling  the  finger  over  the  paper  in 
the  same  manner,  in  this  way  obtaining  a  clear  impression  of  the 
ridges  on  the  surface  of  the  finger.  This  latter  impression  should 
include  both  the  palmar  surface  and  the  sides  of  the  finger  between 
the  tip  and  the  flexure  of  the  last  joint.  Always  roll  the  fingers  from 
the  awkward  position  to  the  natural  position.  (Figs.  3,  4,  and  5.) 


32  PHYSICAL   EXAMINATION    OF    RECRUITS. 

It  is  absolutely  necessary  that  the  finger  prints  shall  be  clear,  that 
the  ridges  shall  be  distinctly  outlined,  and  that  the  "  rolled  "  impres- 
sions shall  be  sufficiently  large  to  include  all  the  points  needed  for 
accurate  classification,  and  free  from  blur.  Black  impressions  are 
better  than  light  ones  if  the  spaces  between  the  ridges  are  free  from 
blur. 

When  the  skin  of  the  fingers  is  in  poor  condition,  make  special 
effort  to  get  best  results. 

Entire  palmar  surface  of  first  joint  should  be  inked  so  that  whole 
contour  of  pattern  will  be  shown  when  finger  is  rolled. 

Recruit  should  first  be  required  to  sign  his  name,  and  then  to 
roll  the  impression  of  the  right  index  finger  in  the  space  above  his 
signature.  This  will  eliminate  entirely  the  possibility  of  the  recruit 
signing  other  than  his  own  identification  record.  Have  only  one 
recruit  at  a  time  present  in  the  room  where  prints  are  being  made, 
and  complete  and  file  each  record  before  the  next  man  enters  or  is 
taken  up.  In  this  way  no  other  record  than  the  one  in  question  is 
available  or  within  reach  of  the  recruit  being  recorded,  therefore 
he  can  sign  no  record  but  his  own.  Do  not  allow  records  to  lie 
around,  but  file  or  otherwise  dispose  of  them  at  once  after  completing 
examination. 

In  taking  impressions,  the  operator  himself  should  manipulate  the 
hands  of  the  recruit,  who  should  be  directed  to  relax  his  fingers  and 
not  to  attempt  to  assist  by  adding  to  the  pressure  on  the  inked  plate 
or  on  the  paper.  In  order  that  the  ink  may  be  taken  up  on  the 
finger  evenly  and  in  sufficient  quantity,  an  unused  part  of  the  plate 
should  be  selected  each  time  for  inking  the  finger,  and  when  no 
unused  part  of  the  plate  remains  the  ink  should  be  redistributed 
with  the  roller  or  the  plate  reinked.  See  that  there  are  no  clots  of 
ink  where  the  fingers  are  to  be  rolled  on  the  plate. 

The  form  holder,  which  is  intended  to  prevent  the  form  from 
moving  about  and  blurring  the  print  while  impressions  are  being 
taken,  will  be  used.  The  best  results  will  be  obtained  with  a  table 
that  places  the  form  holder  at  about  the  height  of  the  elbow  of  the 
recruit  when  he  is  standing  with  his  arms  hanging  at  his  sides.  To 
place  a  form  in  the  holder,  press  out  the  plate  by  means  of  the  levers 
at  the  ends,  place  the  form  in  position  under  the  plate,  and  push 
back  the  levers  to  their  original  position.  The  pressure  of  the  springs 
on  the  plate  will  hold  the  form  firmly  in  position. 

To  record  the  finger  prints  on  Bureau  of  Navigation  Form  No.  2 
and  United  States  Marine  Corps  Form  N.  M.  C.  330,  place  one  of 
the  blank  forms  in  the  holder  (Fig.  2),  with  the  upper  heavy  black 
line  appearing  just  above  the  upper  edge  of  the  plate ;  then  take  the 
rolled  impressions,  in  the  order  named  and  in  proper  spaces  on  the 
form,  of  the  thumb,  index,  middle,  ring,  and  little  fingers  of  the  right 


FIG.  1.— Scrubbing  hands  preliminary  to  inking  fingers. 


^^^^^^^^^^^^^^^^^^^^^^^^I^H 


FIG.  G. — Making  plain  impression  of  fingers. 


FIG.  7.— Making  plain  impression  of  thumb. 


FIG.  8. — Properly  made  record. 


r  fi 

*-  '• '  ft    i\ 

M  %  !! 

in  i; 


FIG.  9. — Face  of  the  record.    Poor  index  print.    Marks  on  outline  figure 
give  no  dimensions. 


L-EFT     HAND. 


t 


FIG.  10.— Imperfect  record.    Useless  for  classification. 


FIG.  11.— Arch. 


FIG.  12.— Tented  arch. 


Point  of  core 


Point 
X*  of  core 


,Delta 


FIG.  13.— Radial  loop,  right  hand,  or  ulnar 
loop,  left  hand. 


Delta  — 


FIG.  14.— Ulnar  loop,  right  hand,  or  radial 
loop,  left  hand. 


FIG.  15.— Whorl.   (2  deltas.) 


FIG.  16.— Composite.    (2  deltas.) 


FIG.  17.— Ulnar  loop  (right  hand),  showing  65  points  of  identification. 


oo  NUT  POLO  TH,S  FORM. 


Classification  No. 

RIQHT     HAND. 


2. 


L-ETT    HAND 


3. 


4. 


AND.  RK3HT     HAND. 


FIG.  18.— 1,  Whorl  improperly  rolled,  showing  only  one  delta;  2,  same  finger  properly  rolled;  3,  loop 
properly  rolled;  4,  same  finger  improperly  rolled. 


PHYSICAL   EXAMINATION   OF   RECRUITS.  33 

hand,  the  impressions  to  be  located  on  the  form  so  that  the  flexure 
of  the  last  joint  is  immediately  above  the  folding  line.  '  This  will 
leave  room  for  a  second  print  to  be  taken  in  the  upper  part  of  the 
space  in  case  the  first  print  is  defective. 

After  the  impressions  of  the  fingers  of  the  right  hand  have  been 
taken,  move  the  form  in  the  holder  until  the  lower  heavy  black  line 
appears  just  above  the  edge  of  the  plate;  then  take  the  rolled  im- 
pressions of  the  fingers  of  the  left  hand  in  the  proper  spaces  on  the 
form. 

After  the  rolled  impression  of  each  finger  of  both  hands  has  been 
obtained,  again  move  up  the  form  in  the  holder  until  the  plate  covers 
only  enough  of  tha  lower  edge  of  the  form  (not  exceeding  one-fourth 
inch)  to  hold  it  in  place.  Then  take  a  plain  impression  of  the  four 
fingers  of  the  right  hand  at  one  time,  the  fingers  being  held  together 
so  as  to  bring  the  prints  within  the  allotted  space,  and  a  similar  plain 
impression  of  the  fingers  of  theleft  hand.  Below  the  finger  impres- 
sions take  a  plain  impression  of  each  thumb. 

The  method  of  obtaining  the  plain  impressions  is  to  take  each  of 
the  fingers  in  turn  and  place  the  Imlbs  only  on  the  inked  plate.  When 
this  is  done,  press  the  recruit's  fingers  together,  and  with  his  hand 
limp  and  flat  (not  bowed  or  arched)  place  it  in  the  space  shown  on 
the  form  and  press  each  finger  at  the  base  of  the  nail,  lightly.  No 
attention  need  be  paid  to  the  deltas  in  the  plain  simultaneous  im- 
pressions, but  the  detail  must  be  clearly  defined.  These  impressions 
are  used  to  determine  if  the  rolled  impressions  are  in  their  proper 
sequence.  (Figs.  6  and  7.) 

A  finger  should  not  be  noted  missing  if  any  portion  of  it  beyond 
the  flexure  of  the  terminal  joint  remains.  The  end  of  a  mutilated 
finger  should,  in  all  cases,  be  inked  and  recorded  as  in  the  case  of  a 
perfect  digit. 

Figure  10  shows  impressions  improperly  taken.  This  record  is  so 
blurred  that  it  is  impossible  to  classify  the  impressions,  and  conse- 
quently is  of  no  value. 

No  amount  of  pressure  by  the  operator  should  be  used  in  making 
or  inking  rolled  impressions.  It  is  the  pressure  that  causes  the  ink 
to  more  readily  run  in  between  the  ridges.  The  finger  tips  should  be 
allowed  to  touch  the  paper  only  with  sufficient  pressure  to  make  a 
record. 

Figure  8  represents  the  only  standard  which  is  satisfactory  and  it 
is  desired  that  no  record  be  forwarded  which  is  not  up  to  the 
standard. 

The  utmost  care  should  be  taken  in  recording  the  impressions  of 
the  little  fingers.  From  these  fingers  a  subclassification  number  is 
obtained. 


34  PHYSICAL  EXAMINATION    OP   RECRUITS. 

When  the  finger-print  side  of  the  form  has  been  completed,  the 
impressions  will  be  inspected  to  make  sure  that  they  are  clear  and  free 
from  blur;  that  all  deltas  are  shown  in  the  rolled  impressions,  and 
that  the  whole  contour  of  the  pattern  is  shown.  The  rolled  impres- 
sions will  also  be  compared  with  the  plain  impressions  for  the  purpose 
of  ascertaining  whether  they  are  recorded  in  proper  sequence.  Any 
defective  impressions  will  then  be  remedied  by  taking  another  print 
in  the  upper  part  of  the  proper  space  or  by  using  a  new  form,  if 
necessary.  If  the  impressions  are  not  recorded  in  proper  sequence, 
a  new  form  must  be  used,  the  old  one  being  destroyed. 

After  the  finger  prints  have  been  taken  and  examined,  the  oppo- 
site side  of  the  form  will  be  filled  out  and  the  personal  description 
completed  by  noting  on  the  outline  figures  the  principal  identification 
marks. 

Before  making  the  entries  on  the  personal  description  side  of  the 
blank,  allow  the  ink  on  the  finger-print  side  to  become  sufficiently 
dry  to  prevent  blurring  by  rubbing.  A  few  minutes  will  be  sufficient 
if  the  form  is  handled  carefully  and  not  rubbed  about  on  the  desk 
while  the  personal  description  is  being  entered.  A  sheet  of  blotting 
paper  placed  under  the  form  will  protect  it  to  some  extent.  If  an 
impression  becomes  blurred  at  any  time,  a  new  impression  must  be 
taken  in  the  upper  part  of  the  proper  space,  or,  if  necessary,  the 
imperfect  form  should  be  destroyed  and  a  new  blank  used. 

A  delta  may  be  formed  by  the  bifurcation  of  a  single  ridge  or 
by  the  abrupt  divergence  of  two  ridges  that  hitherto  had  run  side 
by  side,  thus : 


The  core  of  a  loop  may  consist  either  of  an  even  or  uneven  num- 
ber of  ridges  not  joined  together,  thus: 


Arches. — In  arches  the  ridges  run  from  one  side  to  the  other,  mak- 
ing no  backward  turn.  Arches  have  no  deltas.  (Fig.  11.) 

Tented  arches. — In  patterns  of  the  arch  type  the  ridges  near  the 
middle  may  have  an  upward  thrust,  arranging  themselves,  as  it  were, 
on  both  sides  of  a  spine  or  axis,  toward  which  adjoining  ridges  con- 
verge. The  ridges  thus  converging  give  to  the  pattern  the  appear- 


PHYSICAL   EXAMINATION    OP   RECRUITS.  35 

ance  of  a  tent  in  outline,  hence  the  name  tented  arch.  Tented  arches 
have  no  deltas.  (Fig.  12.) 

In  loops  some  of  the  ridges  make  a  backward  turn  but  without 
twist ;  there  is  one  delta.  If  the  downwai  d  slope  of  the  ridges  about 
the  core  is  from  the  direction  of  the  little  finger  toward  that  of  the 
thumb  it  is  a  radial  loop.  Figure  13  is  a  radial  loop  in  the  right 
hand.  The  heavy  black  line  drawn  from  the  delta  to  the  core  indi- 
cates the  ridges  that  are  counted  in  classifying  loops.  In  this  im- 
pression the  line  cuts  or  crosses  16  ridges.  If  the  downward  slope 
of  the  ridges  about  the  core  is  from  the  thumb  side  toward  the  little 
finger  the  loop  is  ulnar.  Figure  14  is  an  ulnar  loop  in  the  right 
hand  or  a  radial  loop  in  the  left  hand.  In  this  impression  the  heavy 
black  line  crosses  19  ridges.  Be  sure  that  the  delta  is  shown  if  the 
impression  is  a  loop. 

Whorls. — In  whorls  some  of  the  ridges  make  a  turn  through  at 
least  one  complete  circuit.  There  are  two  deltas.  Whorls  are 
single  cored  or  double  cored.  (Fig.  15.)  The  right  and  left  deltas  in 
this  impression  are  shown  by  the  arrowheads.  The  deltas  in  whorls 
must  always  be  shown,  in  order  that  the  tracings  may  be  properly 
made.  In  whorls  the  ridge  traced  starts  from  the  left  delta  and  is 
traced  toward  the  right  delta.  When  the  ridge  whose  course  is 
traced  meets  the  corresponding  right  delta  ridge  the  whorl  is  special- 
ized as  M ;  when  this  ridge  goes  inside  of  the  right  delta  with  three 
or  more  ridges  intervening  it  is  specialized  as  I;  when  the  ridge 
traced  goes  outside  of  the  right  delta  with  three  or  more  ridges 
intervening  it  is  specialized  as  O. 

Figure  16  is  a  composite.  This  pattern  is  classed  as  a  whorl  and 
has  two  deltas.  The  right  and  left  deltas  in  this  impression  are 
shown  by  the  arrowheads. 

Figure  17  shows  ridge  characteristics  used  in  establishing  the 
identity  of  a  person.  Unless  an  impression  is  free  from  blur  great 
difficulty  is  encountered  in  picking  out  the  points  of  comparison 
between  two  impressions.  Sixty-five  points  of  comparison  are  shown 
on  this  impression  which  are  free  from  blur  and  could  all  be  used 
for  purposes  of  comparison  and  identification  with  another  print 
of  the  same  individual. 

Figure  18  (1)  shows  a  whorl  improperly  rolled,  with  only  one  delta 
showing.  It  is  impossible  to  make  a  correct  tracing  of  a  pattern 
rolled  in  this  manner.  Figure  18  (2)  shows  the  same  impression 
properly  rolled. 

Figure  18  (4)  shows  a  loop  improperly  rolled,  with  the  delta 
missing.  The  space  between  the  delta  and  point  of  core  in  loops 
must  be  plainly  shown  and  free  from  blur.  This  pattern  is  of  no 
value  and  can  not  be  properly  classified.  Figure  18  (3)  shows  the 
same  pattern  properly  rolled. 


36  PHYSICAL  EXAMINATION    OF   RECRUITS. 

.  Each  operator  should  instruct  his  relief  in  the  taking  of  finger 
prints,  so  that  the  Bureau  of  Navigation  and  Marine  Headquarters 
will  be  able  to  receive  good  finger-print  impressions  at  all  times. 

The  skin  on  the  finger  tips  of  the  bodies  of  men  which  have  been 
recovered  from  the  water  will  be  greatly  wrinkled  or  shriveled,  so 
that  without  some  treatment  the  making  of  satisfactory  prints  may 
be  difficult  and  even  impossible.  The  way  to  overcome  this  is  to  inject 
water  with  a  hypodermic  syringe  beneath  the  skin  of  the  bulb  of 
the  finger.  This  will  smooth  out  the  skin  for  the  impression. 


HINTS  FOR  THE  INEXPERIENCED  IN  NAVAL  OR  MARINE 
RECRUITING,  ESPECIALLY  THOSE  EXAMINERS  WITH- 
OUT EXPERIENCE  AT  SEA. 

[These  notes  are  not  to  be  considered  as  in  any  way  superseding  the  Navy  Regulations 
and  Naval  Instructions,  or  the  instructions  in  the  Manual  for  the  Medical  Depart- 
ment.] 

"  The  health  of  a  navy  is  primarily  in  the  hands  of  the  medical 
officers  at  the  recruiting  stations." — GATE  WOOD. 

The  recruiting  surgeon  stands  at  the  door,  and  none  enters  unless 
pronounced  physically  fit. 

Your  duty  is  to  safeguard  the  interests  of  both  the  service  and 
the  candidate.  You  should  be  of  .an  open  mind,  and  not  allow  either 
a  sudden  dislike  or  sympathy  to  affect  the  impartiality  of  your  judg- 
ment. 

A  fixed  routine  of  examination  should  be  early  established  and 
rigidly  followed,  as  this  prevents  confusion,  saves  time,  and  is  the 
only  way  to  insure  a  complete  examination. 

A  good  plan  is  to  have  a  strong  light  with  a  reflector  so  arranged 
that  it  will  throw  a  cone  of  bright  light  on  the  candidate,  allowing 
the  examiner  to  stand  in  the  shadow. 

Common  varieties  of  attempted  fraudulent  enlistment  which  the 
examining  surgeon  should  keep  in  mind: 

(a)  Age  falsely  sworn  with  intent  to  deceive. 

(Z>)  Men  who  have  been  previously  rejected  physically  by  the  naval 
or  other  military  service  and  who  deny  the  fact, 

(c)  Deserters  or  men  with  dishonorable  or  medical  discharges  who 
deny  the  fact.  These  men  usually  give  an  assumed  name. 

The  recruiting  line  officer  will  be  vigilant  in  detecting  these  frauds, 
but  the  medical  officer  should  be  on  the  alert  for  them  also,  and  he 
has  many  opportunities  for  detection  that  are  not  open  to  the  recruit- 
ing officer.  A  fraudulent  enlistment  is  almost  certain  to  be  followed 
by  detection,  and  entails  a  loss  of  time  and  money  to  the  Government. 
Even  if  undetected,  most  of  this  class  of  recruits  will  prove  worth- 
less, with  the  possible  exception  of  the  boy  who  lies  about  his  age  in 
order  to  pass  the  minimum  legal  age  limit.  And  perhaps  even  in 
his  case  his  relatives  will  turn  up  and  demand  the  annulling  of  his 
enlistment. 

A  man  who  has  previously  had  a  thorough  physical  examination 
will  often  betray  a  familiarity  with  the  routine.  In  inspecting  the 
anal  region,  if  such  a  candidate  be  told  to  present  his  back  to  the 

37 


38  PHYSICAL  EXAMINATION    OF   RECRUITS. 

examiner  and  stoop  over,  he  will  often  pull  his  buttocks  apart  with- 
out further  instruction.  Then,  if  asked  in  a  casual  voice,  "  Where 
were  you  examined  before?"  he  may  be  caught  off  his  guard  and 
admit  a  previous  examination.  .  With  his  back  to  you,  say  in  a  tone 
of  command,  "  Turn  around."  If  he  does  an  "  about  face,"  the  infer- 
ence is  obvious. 

The  command  to  draw  back  the  foreskin  will  frequently  be  fol- 
lowed by  milking  the  urethra  by  the  sophisticated. 

"  Head  "  is  a  shipboard  term  for  toilet.  If  a  man  is  asked  how 
long  since  he  was  at  the  head,  and  he  understands  it,  he  has  probably 
been  to  sea,  and  in  the  Navy.  Of  course,  he  may  have  heard  it  from 
gome  naval  relative  or  friend. 

An  explanation  of  the  infallibility  of  finger-print  identification, 
and  a  display  of  careful  plotting  of  marks  of  identification  may  be 
followed  by  a  sudden  withdrawal  of  the  candidate.  If  a  candidate 
requests  permission  to  leave  for  a  moment  before  being  sworn  in, 
don't  expect  him  back.  Sometimes  at  an  inland  station  a  man  will 
try  to  enlist  in  order  to  obtain  free  transportation  to  the  coast.  Ex- 
aminers on  Marine  Corps  recruiting  duty  should  be  especially  care- 
ful, as  marine  recruits  are  not  sworn  in  until  they  reach  the  recruit 
depot. 

Tattooing. — Ninety-five  per  cent  of  the  men  who  enlist  in  the  Navy 
fraudulently  by  concealing  previous  military  service  that  is  discov- 
erable are  tattooed  in  a  manner  characteristic  of  the  naval  or  mili- 
tary service. 

This  fact  has  been  demonstrated  by  a  close  observation  of  the 
records  for  the  last  five  years  in  the  identification  office  of  the  Navy. 
As  a  result,  it  has  been  found  that  men  with  certain  tattoo  marks  will 
almost  invariably  be  identified  as  having  served  previous  enlistments 
in  some  branch  of  the  military  service.  A  list  of  the  tell  tale  tattoo- 
ing follows: 

Shoulders  tattooed  with  female  heads  or  figures,  birds,  animals, 
grotesque  figures,  butterflies,  and  stars. 
Butterflies  on  any  part  of  the  body. 
Eagle  and  globe. 

"  C.  A.  C.,"  "  U.  S.  N.,"  "  IT.  S.  A.,"  and  «  U.  S.  M.  C." 
"  Death  before  dishonor,"  "  In  memory  of  my  mother,"  "  In 
memory  of  my  father." 

Tombstone  and  weeping  willow. 

Pig  tattooed  on  foot.  (In  olden  times  it  was  believed  by 
sailors  that  if  they  had  a  pig  tattooed  upon  the  instep  of  the  left 
foot  it  would  be  impossible  to  drown.) 

Men  who  have  "  Manila,  P.  I.,"  or  the  name  of  any  foreign 
port  tattooed  on  their  person  have  invariably  been  found  to  have 
had  military  service. 


PHYSICAL   EXAMINATION   OF   RECRUITS.  39 

Sailor's  head. 

Eagle  and  shield. 

Crossed  guns. 

Apprentice  knot  (figure  of  eight). 

Star  or  other  marks  over  umbilicus. 

Tattooing  on  penis. 

Tattooing  below  waist. 

Obscene  tattooing. 

Tattooing  on  buttocks. 

Designs  such  as  dragons,  flowers,  butterflies,  animals,  and 
Japanese  women  are  used  almost  exclusively  by  the  tattooer  in 
the  Orient. 

Applicants  for  enlistment  who  are  tattooed  in  the  above-named 
manner  should  not  be  enlisted  until  finger  prints  have  been  for- 
warded to  the  Bureau  of  Navigation  to  determine  whether  they  have 
had  prior  service.  Such  men  will  "apply  in  most  cases  for  enlistment 
in  the  ratings  of  coal  passer,  fireman,  ship's  cook,  baker,  seaman,  and 
ordinary  seaman. 

An  obviously  altered  tattoo  mark  should  cause  suspicion.  The 
identification  experts  in  the  Bureau  of  Navigation  have  found  that 
tattoo  marks,  especially  butterflies,  on  the  shoulders  are  more  dis- 
tinctively naval  in  origin  than  any  other.  Extensive  tattooing  does 
not  necessarily  indicate  a  naval  or  even  a  maritime  experience,  but 
even  though  he  be  cleared  of  suspicion  as  a  "  repeater,"  the  young 
idler  who  has  his  skin  covered  with  tattooing  is  often  an  undesirable 
frequenter  of  saloons  and  dives. 

When  the  examination  is  nearly  completed  and  the  confidence  of 
the  suspected  candidate  has  been  won  by  kindly  treatment  and 
friendly  conversation,  he  will  be  off  his  guard,  and  inquiries  as  to 
birthplace,  age,  previous  residence,  previous  illness,  family  history, 
etc.,  may  elicit  a  truthful  answer  where  a  false  statement  was  made 
before. 

Get  an  actual  chest  measure,  without  exaggeration  due  to  muscular 
action  and  posture.  Check  up  your  tape,  measuring  rod,  and  scales 
frequently.  The  tape  stretches,  and  sometimes  a  measuring  rod  will 
become  bent,  and  show  as  much  as  a  half-inch  error. 

Do  not  depend  upon  milking  the  urethra.  Have  the  man  urinate 
in  your  presence.  Many  are  sophisticated  enough  to  urinate  just 
before  examination.  Examine  the  underclothing  for  pus.  If  the 
meatus  is  red  keep  them  in  the  office  long  enough  to  show  whether 
there  is  suppuration. 

Identification. — Be  careful  to  mark  the  missing  teeth  correctly. 
The  space  left  by  a  tooth  extracted  during  childhood  may  be  entirely 
obliterated  by  a  lateral  movement  of  neighboring  teeth,  creating  a 


40  PHYSICAL  EXAMINATION    OF   RECRUITS. 

gap  at  another  place.  Be  sure  you  understand  the  nomenclature  in 
recording  complexion,  eyes,  and  hair. 

Get  as  many  well-defined  marks  of  identification  as  possible,  and 
plot  and  record  them  accurately.  Careful  search  will  nearly  always 
reveal  at  least  five  marks.  Many  descriptive  lists  are  worthless  as  a 
means  of  identification.  Scars  about  knees  should,  of  course,  be 
recorded,  but  they  are  so  common  as  to  be  of  but  little  value  as 
identification.  The  same  may  be  said  of  vaccination  scars. 

Temperature. — In  cases  where  the  skin  feels  unduly  warm  the 
temperature  should,  of  course,  be  taken.  A  fact  noted  by  recruiting 
surgeons  is  that  applicants  very  frequently  display  'a  slight  eleva- 
tion of  temperature,  as  high  as  99.0°,  with  no  discoverable  cause, 
unless  it  be  due  to  nervousness  or  excitement.  According  to  some 
authorities  this  may  be  a  normal  temperature  in  some  individuals, 
with  a  maximum  normal  diurnal  range  of  1.8°  F.  In  these  cases,  if 
the  man  is  otherwise  desirable,  he  should  be  allowed  to  dress  and 
sent  to  the  outer  office  to  talk  to  the  men,  or  on  some  trivial  errand, 
so  that  he  regains  his  composure,  and  the  temperature  be  taken  again 
after  two  hours,  or  on  the  following  day.  If  the  diurnal  maximum 
remains  high,  be  cautious. 

In  case  of  a  disability  which  may  be  temporary,  such  as  bronchitis, 
or  insufficient  weight,  encourage  the  man  to  return  again,  and 
perhaps  offer  him  advice  as  to  how  to  overcome  the  defect.  It  has 
been  found  that  the  bronchitis  of  cotton-mill  workers  does  not 
clear  up.  Many  applicants  are  below  wreight  simply  because  of 
insufficient  nourishment.  In  many  cities  the  aid  of  charitable  organi- 
zations may  be  obtained  for  these  men  in  the  way  of  obtaining  tem- 
porary employment  or  food  and  shelter. 

If  you  have  reason  to  inquire  about  possible  symptoms,  do  not 
say  "  Do  you  feel  so-and-so  ?  ",  but  ask  leading  questions,  as  if  the 
possession  of  such  symptoms  were  a  matter  of  course,  as  "  How  many 
times  do  you  get  up  at  night  to  urinate?  ",  "  How  much  weight  have 
you  lost  ?  ",  "  How  much  do  your  ears  discharge  ?  " 

In  cases  where  it  is  possible  to  remove  disqualifications  by  surgical 
means,  in  many  cities  arrangements  can  be  made  with  local  hospitals 
to  admit  these  cases  for  early  operation  upon  a  note  or  card  from  the 
examining  surgeon.  There  may  be  retired  naval  medical  officers  or 
Medical  Reserve  Corps  officers  in  the  vicinity  who  practice  a  specialty 
or  are  connected  with  hospitals  who  could  be  of  assistance  in  this 
respect.  In  any  case,  make  it  clear  to  the  candidate  that  enlistment 
can  not  be  guaranteed  after  the  operation.  Inform  applicant  of 
probable  time  of  convalescence  and  time  before  he  could  be  enlisted 
if  operation  proves  a  success.  Capable  dentists  may  be  found  who 
would  do  work  for  a  reduced  fee  to  remove  disqualifications.  A  local 
hospital  may  be  found  to  make  laboratory  examinations. 


PHYSICAL  EXAMINATION   OF   RECRUITS.  41 

It  sometimes  happens  that  an  examiner  will  become  impressed  by 
some  particular  defect,  especially  if  some  recruit  passed  by  him  was 
later  invalided  for  that  defect,  and  will  get  into  the  habit  of  being 
too  exacting  concerning  it. 

Try  to  get  the  strong,  active  men.  Many  will  have  no  organic 
defects  and  may  be  able  to  squeeze  past  the  height  and  weight  require- 
ments, and  still  not  be  nearly  as  desirable  physically  as  another  who 
may  be  robust  and  vigorous,  but  has  some  minor  disqualification, 
which  might  be  waived  by  the  department.  As  an  instance,  relaxed 
external  inguinal  rings  should  not  be  too  severely  considered. 

When  a  report  or  survey  is  sent  to  the  recruiting  surgeon,  he  should 
profit  by  the  knowledge  gained,  but  he  should  not  allow  it  to  make 
him  too  timid.  It  does  not  necessarily  indicate  implied  inefficiency 
or  carelessness,  except,  of  course,  in  the  case  of  some  such  obvious 
defect  as  an  ankylosed  joint  or  grossly  defective  vision  or  hearing. 

If  a  man  gives  Arizona,  Colorado,  or  other  well-known  locality 
for  tuberculous  invalids  as  a  previous  residence,  be  especially  careful 
in  the  chest  examination. 

The  attitudes  of  the  candidate,  and  of  the  same  man  after  he 
becomes  a  recruit,  may  be  diametrically  opposed.  The  shiftless,  lazy 
individual  while  being  examined  for  enlistment  will  endeavor  to 
conceal  the  same  defect  that  he  may  be  exaggerating  in  a  short  time, 
after  he  has  become  tired  of  a  regulated  life  and  of  regular  work. 
The  pinch  of  winter  or  of  hard  times  will  diminish  the  rheumatic 
twinges  or  sharpen  the  hearing  at  the  recruiting  station,  but  the 
advent  of  spring  and  the  lure  of  the  road  will  have  an  opposite  effect 
upon  the  same  man  after  he  has  become  a  coal  passer. 

Do  not  forget  that  your  candidate  is  undergoing  an  experience 
probably  unique  to  him,  and  his  embarrassment  and  desire  to  appear 
self-possessed  may  cause  him  to  appear  surly  and  flippant,  when 
such  traits  may  ordinarily  be  foreign  to  his  disposition.  A  candidate 
treated  with  kindness  and  consideration  becomes  an  aid  to  recruiting, 
whether  accepted  or  not,  and  will  be  the  cause  of  other  applications 
being  made,  and  it  takes  a  great  many  applications  to  furnish  the 
needed  good  material.  Be  searching  in  your  examination,  but  patient 
and  considerate. 

The  regulations  prescribe  that  a  man  shall  be  examined  only  when 
clean  and  sober.  If  he  is  drunk,  he  should  not  be  examined,  then  or 
subsequently,  as  he  is  undesirable.  If  his  body  is  unclean,  the  cir- 
cumstances should  be  taken  into  consideration,  as  they  may  be  beyond 
his  control.  Some  of  these  men  come  long  distances  to  reach  the 
recruiting  station,  and  many  have  had  to  travel  without  money, 
riding  on  freight  trains,  sleeping  in  haystacks,  and  cleanliness  may 
have  been  impossible,  especially  in  cold  weather.  Unless  a  man 
shows  signs  of  long-continued  dirt,  and  is  unashamed  of  it,  he  may 


42  PHYSICAL  EXAMINATION   OF  RECRUITS. 

not  be  undesirable.  The  most  unclean  man  may  be  desirable,  if  he 
voluntarily  apologizes  and  can  give  an  acceptable  explanation. 

In  many  cities  inquiry  will  usually  reveal  some  place  to  which  a 
man  may  be  sent  for  a  free  bath,  if  there  are  no  bathing  facilities  in 
the  recruiting  office. 

The  examination  of  the  skulls  of  men  with  long  hair  should  be 
careful.  A  most  marked  asymmetry,  or  depression,  or  extensive 
postoperative  scar  may  be  concealed  by  the  hair. 

Real  bromidrosis  is  a  sufficient  cause  for  rejection.  Aboard  ship 
the  men  sleep  very  near  each  other,  head  to  feet,  sometimes  in  a 
close  atmosphere,  and  the  man  with  ill-smelling  feet  wrill  be  a  general 
nuisance,  and  will  be  made  miserable  himself  by  his  neighbors' 
wrath. 

Heart  murmurs. — If  after  careful  examination  you  are  convinced 
that  a  murmur  is  functional,  do  not  hesitate  to  recommend  a  waiver 
if  the  candidate  is  otherwise  sound. 

Hearing  test. — Use  whispered  voice,  with  residual  air.  Use  num- 
bers instead  of  sentences,  as  one  or  two  words  heard  may  enable  the 
candidate  to  guess  at  the  others  in  a  sentence.  Many  recruiting 
stations  will  not  afford  a  room  of  sufficient  size  and  quietness  to  make 
an  accurate  voice  test.  In  such  case,  if  a  room  is  available  where  the 
watch  test  may  be  more  accurately  applied,  this  should  be  used,  but 
the  change  should  be  indicated  on  the  record.  The  watch  used  as 
the  standard  at  the  Naval  Academy,  at  40  inches,  is  the  Ingersoll- 
Trenton. 

It  is  easier  to  deceive  the  examiner  in  the  watch  test  than  with  the 
voice.  The  eyes  must  be  kept  carefully  covered,  and  the  candidate 
should  not  be  allowed  to  cover  his  own  eyes.  Of  course,  the  briefest, 
most  indirect  glance  will  suffice  to  inform  the  man  whether  he  should 
hear  the  watch.  The  movement  of  the  examiners  arm  as  he  raises 
and  lowers  the  watch  may  be  perceptible  to  the  candidate  through 
friction  of  clothing,  etc.,  and  enable  him  with  luck  to  make  three  or 
four  accurate  guesses.  It  is  better  not  to  ask  "  Do  you  hear  it  now  ?" 
every  time  you  move  the  watch,  but  better  have  him  tell  you  the 
instant  he  hears  it  or  loses  it.  Do  not  be  too  brief,  as  even  random 
guesses  may  hit  the  mark  two  or  three  times  in  succession. 

Some  examiners  use  two  watches,  one  ticking  and  the  other  silent. 
In  this  case  the  eyes  need  not  be  covered,  and  the  test  becomes  also 
one  of  veracity. 

A  man  may  be  confused  by  the  ticking  of  his  own  watch. 

If  you  use  the  voice  test,  try  your  voice  on  a  person  with  known 
good  hearing,  as  it  may  be  indistinct. 

Always  use  a  speculum  in  examing  ears.  Get  a  clear  view  of  the 
eardrum  in  every  case.  During  the  10-year  period  1905-1914  middle- 
ear  disease  ranked  seventh  in  frequency  as  a  cause  for  medical  dis- 
charge. 


PHYSICAL  EXAMINATION   OF   RECRUITS.  43 

Vision  test. — Look  out  for  the  peeper.  See  that  the  eye  not  being 
tested  is  thoroughly  and  continuously  covered.  Do  not  let  the  candi- 
date cover  his  own  eye.  Cover  the  unused  eye  with  something  which 
does  not  touch  the  eye,  as  the  pressure  of  a  towel  may  blur  a  good 
vision.  Have  a  card  with  a  slot  only  large  enough  to  show  five  or  six 
letters  of  the  test  card.  Be  careful  that  the  margins  of  the  opening 
do  not  cast  a  shadow  on  the  type.  To  be  sure  of  uniformly  good 
illumination  it  is  best  to  have  a  32-candlepower  light,  with  reflector, 
above  the  card. 

The  Grow  cards  are  recommended  for  several  reasons: 

These  cards  all  have  a  uniform  type,  fulfilling  Snellen's  principle, 
while  the  ordinary  commercial  Snellen's  cards  in  this  country  show 
a  wide  divergence  in  size  and  shape  of  letters. 

The  greater  number  of  letters  makes  possible  many  more  combina- 
tions, with  less  chance  of  deception. 

The  ordinary  Snellen  card  with  large  letters  at  the  top  gives  a  cue 
to  the  candidate  who  may  have  memorized  that  card. 

Be  thorough  in  the  examination  of  the  eys.  Trachoma  is  more 
prevalent  in  this  country  than  is  generally  believed,  as  shown  by  a 
survey  made  by  the  United  States  Public  Health  and  Marine-Hospi- 
tal Service  in  certain  sections  of  the  South. 

Beware  the  "weak  sister"  of  effeminate  mannerisms.  He  will 
probably  sink  under  the  fire  of  his  shipmates'  raillery  and  sarcasm. 
The  sailor  man  is  unmerciful  in  his  jibes  at  a  man  so  unfortunate  as 
to  possess  any  marked  peculiarities,  either  of  person  or  manner.  For 
the  same  reason  the  candidate  with  huge,  outstanding  ears  or  other 
very  prominent  features  should  cause  reflection,  unless  he  possesses 
the  physical  size  and  disposition  to  enforce  respect. 

Drug  habitues. — Always  look  for  the  hyperemia  or  ulceration 
of  the  nasal  mucosa  due  to  cocaine  or  heroin  snuffing,  and  marks  of 
needle  punctures  in  the  skin. 

Every  recruiting  station  has  a  laudable  ambition  to  secure  as 
high  a  percentage  of  recruits  as  possible,  but  the  medical  examiner 
should  not  allow  this  desire  to  interfere  with  his  judgment. 

Extracts  from  "Weak  Foot,"  by  Surg.  R.  C.  Holcomb,  United 
States  Navy,  reproduced  from  United  States  Naval  Medical  Bulletin : 

Weak  foot,  commonly  called  pes  planus,  flat  foot,  and  splay  foot,  is  a  frequent 
cause  for  rejection  of  applicants  for  enlistment  in  the  Army  and  Navy.  The 
condition  is  of  sufficient  importance  for  a  careful  examination  into  the  subject 
with  a  view  to  determining  its  full  significance,  not  only  as  a  cause  for  rejec- 
tion among  applicants  for  enlistment  but  also  as  a  cause  of  disability. 

The  Navy  statistics  for  weak  foot  or  flat  foot  as  a  cause  for  rejection  are  not 
available  before  1912.  For  this  year,  however,  out  of  a  total  of  78,180  applicants 
for  enlistment  4,534,  or  57.99  per  1,000,  were  rejected  on  account  of  flat  foot.  In 
1914  the  ratio  was  108  per  1,000,  and  in  1915  it  was  79  per  1,000. 


44  PHYSICAL  EXAMINATION   OF  KECRUITS. 

Bearing  in  mind  the  normal  low  arch  in  savage  races,  the  diagnosis  of  weak 
foot  must  be  judged  not  only  by  the  appearance  of  the  foot  but  largely  from 
its  function.  The  main  symptoms  as  pointed  out  by  Whitman  (Orthopedic 
Surgery)  group  under  the  following  heads: 

1.  Attitude. 

2.  Distribution  of  weight  and  strain. 

3.  Contour. 

4.  Height  of  arch. 

5.  Bearing  surface. 

6.  Range  of  motion. 

7.  Pain. 

Attitude. —  (a)  The  heel  walk;  (&)  exaggerated  turning  out  of  the  foot. 
These  two  symptoms  are  not  of  necessity  early  symptoms.  The  cause  of  the 
heel  walk  with  its  tendency  to  take  the  weight  off  the  arch  of  the  foot  is  not 
alone  the  result  of  the  weakness,  but  also  an  effort  to  ease  the  arch.  The 
exaggerated  turning  out  of  the  foot  needs  little  comment.  *  *  *  A  weak- 
ness of  the  structures  which  tie  the  arch  would  result  in  the  sinking  of  the 
astragalus  and  its  wedging  more  deeply  between  the  articular  surface  of  the 
calcaneum  and  navicular,  thus  turning  the  anterior  structure  outward.  There 
is  also  an  effort  of  the  individual  to  ease  the  inner  arch  by  throwing  as  much 
weight  as  possible  on  the  outer  arch  of  the  foot.  Have  the  patient  walk  and 
note,  if  the  foot  is  properly  used,  whether  the  great  toe  points  to  the  median  line 
or  turns  away.  Note  where  the  line  of  the  tibia  falls,  whether  over  the  second 
toe  or  inside  the  great  toe. 

Distribution  of  weight  and  strain. —  (a)  Examine  shoe. 

(1)  Observe  signs  of  bulging  inward  at  the  arch   (look  for  the  impress  of 
mechanical  arches,  or  the  clean  area  in  contrast  with  the  rest  of  the  lining  in 
those  who  have  worn  arches). 

(2)  Observe  wearing  away  of  the  inner  sole  of  the  shoe. 
(&)  Compare  the  shoe  with  the  bare  foot. 

The  wearing  of  the  heel  and  sole  of  the  shoes,  and  the  misshape,  a  result  of 
strain  on  the  uppers,  are  valuable  bits  of  evidence  which  will  show  in  a  good 
measure  the  strength  or  weakness  of  the  foot  that  has  been  incased  within  the 
shoe. 

Contour. — With  the  applicant  standing,  observe  the  feet  placed  side  by  side, 
the  two  internal  malleoli  and  the  metatarso-phalangeal  joints  touching.  In 
normal  feet  a  slight  interval  remains  between  them  due  to  the  concavity  along 
the  inner  border.  In  weak  feet  the  concavity  is  replaced  by  a  convexity  and 
an  attempt  at  adduction  is  accompanied  by  an  inturning  of  the  patellae  and 
crests  of  the  tibia.  According  to  Whitman,  "this  change  of  contour  is  the 
earliest  and  sometimes  the  only  evidence  of  weakness." 

Height  of  the  arch. — The  height  of  the  arch  is  measured  as  the  distance  from 
a  line  drawn  between  (a)  the  lower  border  of  the  internal  malleolus  and  (ft) 
the  lower  tubercle  on  the  head  of  the  first  metatarsal  (Feiss  line)  to  (c)  the 
tubercle  of  the  scaphoid,  which  distance  should  not  exceed  one-half  inch. 

It  should  be  understood  that  this  measurement  is  relative,  and  is  simply  a 
measurement  of  proportion  in  the  average  foot.  A  small  foot  might  well  have 
a  measurement  less  than  this  and  still  be  within  normal  limits,  while  a  foot 
larger  than  the  average  will  give  a  proportional  measurement  of  much  greater 
than  one-half  inch.  About  5  per  cent  of  the  cases  examined  seem  to  show  a 
deficiency  in  this  measurement,  and  this  conforms  very  closely  to  the  Army 
and  Navy  average  of  rejections  for  flat  foot. 

Bearing  surface. — An  imprint  taken  with  the  finger-print  apparatus  will  show 
the  shape  of  the  bearing  surface  of  the  foot.  While  this  may,  when  present 


PHYSICAL   EXAMINATION-   OF   RECRUITS.  45 

in  a  normal  degree,  serve  to  assist  in  forming  an  opinion,  on  the  other  hand 
if  the  imprint  is  flat,  in  the  absence  of  other  symptoms  it  would  not  be  suf- 
ficient to  warrant  a  diagnosis  of  weak  foot.  The  fatty  pad  under  the  arch 
which  is  normally  present  in  the  young,  the  highly  developed  plantar  muscles 
in  the  savage  tribes,  or  in  those  not  bred  to  the  shoe,  all  serve  to  discount 
the  value  of  this  imprint  as  an  aid  to  diagnosis.  According  to  Whitman: 
"Of  all  the  tests,  this,  so  often  used  to  demonstrate  the  height  of  the  arch  and 
thus  confirm  a  diagnosis  of  flat  foot,  is  of  least  importance." 

Range  of  motion. — The  range  of  motion  in  examining  the  foot  should  include 
flexion,  abduction  and  adduction. 

Under  normal  circumstances  the  foot  will  show  a  concavity  along  its  inner 
surface,  and  a  line  along  the  crest  of  the  tibia  continued  over  the  foot  falls 
over  the  second  toe.  Voluntary  dorsal  and  plantar  flexion  is  accomplished 
by  the  movement  of  the  astragalus  upon  the  leg  bones  between  the  internal 
and  external  malleoli.  Dorsal  flexion  is  normally  between  10°  and  20°  less 
than  a  right  angle  between  the  foot  and  leg.  Plantar  flexion  is  much  greater 
and  is  between  50°  and  60°  more  than  a  right  angle  between  the  foot  and  leg. 

During  voluntary  abduction  and  adduction  the  astragalus  is  practically  fixed 
between  the  internal  and  external  malteoli,  and  the  foot  moves  on  the  astraga- 
lus. The  actual  range  of  adduction,  while  difficult  to  measure,  is  about  30° 
from  the  line  continued  from  the  crest  of  the  tibia;  abduction  is  about  15° 
from  this  line. 

Voluntary  adduction  or  inversion  of  the  foot,  is  the  most  important  test 
of  all  motions  to  show  the  weakness  of  the  foot.  Extend  the  leg;  keep  the 
crest  of  the  tibia  fixed  in  the  median  line,  then  have  the  patient  turn  the  foot 
inward  as  far  as  possible  without  rotating  the  leg.  According  to  Whitman: 
"Even  mild  and  early  cases  of  weak  foot  usually  show  some  limitation  of  this 
most  important  motion,  and  in  many  instances  it  is  completely  lost,  the  patient 
turning  the  entire  limb  in  the  effort  to  adduct  the  foot." 

The  question  naturally  presents  itself:  What  degree  of  weak  foot  may  be 
accepted  for  service?  It  is  certain  that  a  large  number  of  cases  of  weak  foot 
are  enlisted  without  being  recognized.  I  think,  as  a  general  rule,  any  man  in 
whom  the  scaphoid  tubercle  is  not  depressed  beyond  one-half  inch  below  the 
Feiss  line,  and  who  can  adduct  the  feet  each  between  25°  and  30°  from  the  line 
continued  along  the  crest  of  the  tibia,  may  be  accepted  as  attaining  a  standard. 
It  is  well  also  to  observe  the  contour  of  the  inner  border  of  the  foot,  the  feet 
being  placed  side  by  side,  noting  any  beginning  downward  and  inward  displace- 
ment of  the  astragalus. 

What  degree  of  flat  foot  should  constitute  a  disability?  I  think  this  must 
depend  largely  upon  the  man's  rate.  We  would  naturally  expect  less  disability 
for  this  cause  in  the  yeoman  than  in  the  marine,  whose  duty  is  largely  a  ques- 
tion of  feet. 

In  examining  the  teeth,  look  for  proper  occlusion.  Even  though 
few  or  no  teeth  are  missing,  many  of  them  may  be  useless  because  of 
lack  of  occlusion.  In  young  men  with  evident  general  disintegration 
of  the  teeth,  they  may  be  poor  risks  even  if  repaired  sufficiently  to 
meet  the  requirements.  Naval  dental  surgeons  are  not  authorized  to 
do  crown  or  bridge  work. 

A  row  of  clothes  hooks,  a  mirror,  and  a  buttonhook  are  recom- 
mended. 

It  is  well  not  to  allow  any  doubt  you  may  have  in  your  mind  about 
passing  a  defect  to  be  apparent  to  the  candidate.  He  may  possibly 


46  PHYSICAL  EXAMINATION   OF  RECRUITS. 

make  capital  of  it  later  in  an  attempt  to  get  a  medical  discharge  for 
"  cause  existing  prior  to  enlistment." 

In  filling  out  rejection  report,  regardless  of  whether  waiver  be  or 
be  not  recommended,  be  sure  to  describe  every  defect  even  though 
some  may  be  of  such  minor  importance  that  if  any  one  existed  alone 
it  would  not  be  considered  a  disqualification.  In  considering  a  recom- 
mendation on  these  reports  it  is  necessary  that  the  bureau  should 
have  a  clear,  composite  picture  of  the  physical,  mental,  and  moral 
status  of  the  candidate.  In  forwarding  telegraphic  requests  for 
waiver  of  deficient  height,  weight,  or  chest  measurement,  always 
include  all  three. 

Have  the  men  at  substations  forward  the  addresses  of  men  rejected 
by  them  if  there  is  any  possibility  that  they  may  be  accepted  by  the 
medical  officer.  Have  the  substation  men  encourage  these  men  to  go 
to  the  main  office  for  examination,  or  to  present  themselves  at  the 
substation  on  the  next  visit  of  the  medical  officer,  if  such  visits  are 
made.  Recommend  that  men  before  going  to  duty  at  a  substation  be 
given  a  thorough  course  of  instruction  at  the  main  office. 

Hemorrhoids. — In  any  case  of  tendency  to  varix  or  varicocele  be 
especially  careful  in  looking  for  internal  hemorrhoids. 

FORMS   USED   BY    MEDICAL   OFFICERS    ON    RECRUITING   DUTY. 

Form  4:  Request  for  supplies  (par.  3933,  Manual). 

Form  Ca  and  Ca  1:  Survey  of  property  (par.  2961,  Manual). 

Form  D  and  Da  1 :  Inventory  of  property  (par.  3935,  Manual). 

Form  F  (rough) :  Abstract  of  patients  (par.  2357,  Manual). 

Form  G:  Hospital  ticket  (par.  3937,  Manual). 

Form  H:  Health  records  (par.  2241,  Manual). 

Form  H :  Descriptive  sheets. 

Form  L:  Request  for  medical  survey  (par.  2921,  Manual). 

Form  M:  Report  of  medical  survey  (par.  2931,  Manual). 

Form  N:  Report  of  death  (par.  2431,  Manual). 

Form  O :  Request  for  blank  forms. 

Form  X  and  Form  X  (rough),  already  described. 

Changes  in  Hospital  Corps  (par.  3953,  Manual). 

These  forms  are  described  in  the  parts  of  the  Manual  to  which 
reference  is  made.  Explanatory  notes  are  also  printed  on  the  various 
forms. 

The  original  recruiting  outfit  is  as  follows :  Vision  test  set,  urinary 
test  set,  stethoscope,  thermometer,  otoscope,  ophthalmoscope,  tape- 
line,  and  wooden  tongue  depressors. 

Additional  supplies  of  these  articles  are  obtained  by  requisition, 
Form  4.  The  stethoscope,  otoscope,  and  ophthalmoscope  are  not  ex- 
pendable, and  must  be  accounted  for,  and  if  lost  or  damaged  must 
be  surveyed.  The  other  articles  are  expendable. 


PHYSICAL   EXAMINATION   OF   RECRUITS.  47 

The  medical  officer  is  assisted  by  an  enlisted  man  of  the  Hospital 
Corps,  who  records  the  findings  dictated  by  the  medical  officer.  The 
Hospital  Corps  man  should  give  the  necessary  instructions  to  candi- 
dates to  facilitate  smoothness  of  procedure.  He  should  be  on  the 
alert  during  the  presence  of  the  candidate  in  the  office  for  any  inci- 
dent that  may  escape  the  notice  of  the  examiner.  He  may  be  allowed 
to  make  the  finge-print  records,  after  he  has  demonstrated  his 
competence  to  do  so.  The  prints  should  be  carefully  examined  by 
the  medical  officer  in  all  cases.  He  may  be  given  the  care  of  the 
instruments  and  apparatus.  He  may  assist  in  the  vision  and  hearing 
tests.  In  case  of  illness  among  the  personnel  of  the  office,  he  may 
act  as  nurse  in  so  far  as  it  does  not  interfere  with  the  primary  duty 
of  the  station  to  secure  recruits. 

The  recruiting  medical  officer  has  the  medical  care  of  the  officers 
and  men  of  the  Navy  and  Marine  Corps  attached  to  the  station  and 
in  that  vicinity,  unless  otherwise  .provided.  Medicines  and  necessi- 
ties, except  as  above  noted,  are  not  furnished  by  the  department,  but 
are  procured  from  local  sources  on  prescription. 

In  the  event  of  necessary  hospital  treatment,  the  patient  shall  be 
sent  to  a  suitable  local  hospital,  as  provided  in  article  4532  (1), 
Navy  Regulations,  as  follows : 

Officers  and  enlisted  men  of  the  Navy  and  Marine  Corps  when  on  duty  at  a 
place  where  there  is  no  naval  hospital,  may  be  sent  to  other  hospitals  upon  the 
order  of  the  commander  in  chief,  or  the  senior  officer  present,  and  the  expenses 
of  such  persons  shall  be  paid  from  the  naval  hospital  fund,  and  no  other 
charge  shall  be  made  against  their  accounts  than  such  as  are  made  for  persons 
under  treatment  at  naval  hospitals. 

Bills  for  medical  attendance  upon  enlisted  men,  for  medicines  and 
surgeon's  necessaries,  and  for  treatment  in  hospital  shall  be  properly 
made  out  and  certified  to  by  the  medical  officer  and  submitted 
promptly  to  the  Bureau  of  Medicine  and  Surgery  before  payment, 
accompanied  by  a  letter  of  advice  giving  the  disease  or  injury  on 
account  of  which  the  expenses  were  incurred.  Upon  all  copies  of 
public  bills  for  such  expenses  the  medical  officer  will  certify  that 
Navy  medical  supplies  were  not  available,  or  that  the  services  of  a 
Navy  medical  officer  could  not  be  had,  or  that  treatment  in  hospital 
was  necessary.  (Art.  4534,  Navy  Regulations. ) 

No  expenses  for  medicines  for  or  medical  attendance  upon  a  naval 
officer  will  be  included  in  the  account  current. 


PHYSICAL  EXAMINATION  OF  THE  PERSONNEL  OF  THE 
NAVAL  MILITIA  PRIOR  TO  BEING  MUSTERED  INTO  THE 
SERVICE  OF  THE  UNITED  STATES. 

1.  All  officers  and  enlisted  men  must  undergo  this  examination 
before  mustering,  regardless  of  any  prior  physical  examination.  • 

2.  The  examination  will  be  conducted  by  medical  officers  of  the 
Navy,  or  by  medical  officers  of  the  Naval  Militia  in  the  service  of 
the  United  States,  who  have  qualified  as  such,  physically  and  pro- 
fessionally, and  have  been  mustered  in. 

3.  The  physical  requirements  are  prescribed  in  General   Order 
No.  150. 

4.  Minor  or  temporary  physical  disqualifications  may  be  recom- 
mended to  the  Navy  Department   (Bureau  of  Navigation  or  head- 
quarters, United   States  Marine  Corps,  as  the  case  may  be)    for 
waiver,  using  the  prescribed  form,  but  a  suitable  note  of  such  physical 
disqualifications  shall  be  made  a  part  of  the  descriptive  list  of  the 
individual.     If  a  waiver  be  granted,  this  shall  be  recorded  in* red 
ink  in  the  proper  place  on  page  2  of  the  health  record,  as  follows: 
"Defective  vision  waived  by  Bu.  Nav.  (or  Maj.  Gen.  Commandant) 
6-1-16."    This  shall  also  be  entered  in  the  descriptive  list  of  the 
service  record. 

5.  New  health  records  will  be  opened  for  all  officers  and  enlisted 
men.    Where  Navy  health  records  have  been   adopted   as  "  State 
health  records,"  a  copy  of  entries  in  the  vaccination,  typhoid  pro- 
phylactic, and  dental  records,  and  in  the  abstract  of  health  record, 
will  be  entered  in  the  proper  places  in  the  new  health  record.     The 
State  health  record  will  be  closed  and  forwarded  to  the  Division  of 
Naval  Militia  Affairs.     The  new  health  record  shall  have  noted  on 
its  face  in  red  ink,  "Naval  Militia  in  the  service  of  the  United 
States." 

6.  All  officers  and  enlisted  men  will  be  vaccinated  (cowpox)  im- 
mediately after  muster  into  the  service  of  the  United  States  unless 
there  is  a  well-marked  recent  vaccination  scar,  or  two  pitted  vac- 
cination scars  of  older  origin,  or  evidence  of  a  previous  attack  of 
smallpox   (I  3211).     Officers  and  enlisted  men  will  also  be  given 
the  typhoid  prophylactic,  unless  the  State  health  records  show  that 
they  have  received  it  within  a  period  of  four  years  preceding,  or 
that  they  are  over  45  years  of  age,  or  have  had  a  previously  well- 
defined,  attack  of  typhoid  fever  (I  3212). 

'48 

o 


THIS  BOOK  IS  DUE  ON  THE  LAST  DATE 
STAMPED  BELOW 


AN  INITIAL  FINE  OF  25  CENTS 

WILL  BE  ASSESSED  FOR  FAILURE  TO  RETURN 
THIS  BOOK  ON  THE  DATE  DUE.  THE  PENALTY 
WILL  INCREASE  TO  SO  CENTS  ON  THE  FOURTH 
DAY  AND  TO  $1.OO  ON  THE  SEVENTH  DAY 
OVERDUE. 


MOV  22 1S4 


23Mar!5! 


H  E 


LD  21-100m-7,'40 (6936s) 


Caylord  Bros. 

Makers 
Syracuse.  N.  Y. 

PAT.  JAN.  21,  1908 


YC  62463 


1/5; 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 


